Premature or early bilateral oophorectomy: a 2021 update

W. A. Rocca, M. M. Mielke, L. Gazzuola Rocca, E. A. Stewart

Research output: Contribution to journalReview articlepeer-review


In this invited review, we discuss some unresolved and controversial issues concerning premature (<40 years) or early (40–45 years) bilateral oophorectomy. First, we clarify the terminology. Second, we summarize the long-term harmful consequences of bilateral oophorectomy. Third, we discuss the restrictive indications for bilateral oophorectomy in premenopausal women to prevent ovarian cancer that are justified by the current scientific evidence. Fourth, we explain the importance of estrogen replacement therapy when bilateral oophorectomy is performed. Hormone replacement therapy is indicated after bilateral oophorectomy until the age of expected natural menopause like in premature or early primary ovarian insufficiency. Fifth, we discuss the relationship between adverse childhood experiences, adverse adult experiences, mental health, gynecologic symptoms and bilateral oophorectomy. The acceptance and popularity of bilateral oophorectomy over several decades, and its persistence even in the absence of supporting scientific evidence, suggest that non-medical factors related to sex, gender, reproduction, cultural beliefs and socioeconomic structure are involved. We discuss some of these non-medical factors and the need for more research in this area.

Original languageEnglish (US)
Pages (from-to)466-473
Number of pages8
Issue number5
StatePublished - 2021


  • Bilateral oophorectomy
  • cancer prevention
  • early ovarian insufficiency
  • estrogen replacement therapy
  • genetic variants
  • ovarian cancer
  • premature ovarian insufficiency

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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