To Keep Ovaries, Or Not?
This is not something I personally had to navigate, but I see it come up in the community over and over again, so I had to write about it.
Firstly, I just want to acknowledge how big this decision is.
And also… let’s take a moment for the fact that we even have a choice. There was a time not that long ago where women didn’t.
If you’ve come here hoping I’ll give you a clear answer, I won’t. I’m sorry.
Because the truth is, this is deeply personal. It depends on your body, your medical history, your age, your risk factors, and honestly… your gut feeling.
But what I can do is share what I’ve seen, heard and learned from hundreds of women who have been exactly where you are now. You can watch back over this TikTok and this TikTok as you will find the comments section very interesting, and it’s where lots of my thoughts come from.
The conversations happening in clinic rooms
I’ve lost count of how many messages I’ve received about this decision, and there are a few phrases that come up again and again from surgeons:
“We might as well take them while we’re there.”
“You don’t want to have another surgery later.”
“It will remove the risk of ovarian cancer.”
And underneath all of this, there are two very real fears driving the decision:
Fear of another surgery
Fear of cancer
Both completely valid. Both heavy. And both enough to make this decision feel overwhelming.
“If you keep your ovaries, you won’t go into menopause”
This is something I hear a lot, and it’s not true.
If you keep your ovaries, you will still go into menopause at some point, just like every other woman. The difference is that without your womb, you no longer have periods as a marker, so it can be much harder to recognise when it’s happening.
Also, after a hysterectomy, ovaries can sometimes take a while to “wake up” again after surgery. For some women, they never fully do.
This means you might experience menopause symptoms quite quickly… even if you’ve kept your ovaries.
And here’s the part that doesn’t get talked about enough:
It can actually be harder to get support.
Because you still “have your ovaries”, some doctors assume they’re working perfectly, even when your symptoms are telling a different story.
When you know something isn’t right
I remember speaking to a woman called Kelly during an interview. You can listen to that here.
She had kept her ovaries during her hysterectomy, and afterwards, she found herself in a really dark place, struggling with her mental health in a way she hadn’t experienced before.
She knew something wasn’t right.
But it took her a long time to be heard, because she was told:
“You still have your ovaries”
“You’re not the right age for menopause”
Eventually, she did get the support she needed, but it wasn’t easy.
And I’m sharing this not to scare you, but to prepare you.
If you choose to keep your ovaries and you start experiencing symptoms, low mood, anxiety, sleep issues, brain fog, hot flushes, you may need HRT.
And you may have to advocate a little harder for yourself to get it.
What I’ve seen from the community
After speaking to hundreds of women, there isn’t a clear “right” answer, but there are patterns.
Some women who kept their ovaries are really happy they did, especially if they’ve had no ongoing issues.
Others have gone on to experience pain, cysts, endometriosis recurrence, or needed further surgery, and wish they’d had them removed at the time.
Some women who had their ovaries removed feel huge relief, especially if they were dealing with chronic pain or high cancer risk, but have had to navigate surgical menopause and HRT.
There’s no one story. Just lots of different outcomes.
Endometriosis, adenomyosis & recurrence
If your hysterectomy is due to endometriosis or adenomyosis, this is an important conversation to have.
One thing that comes up often in the community is the risk of symptoms returning, particularly with endometriosis.
So it’s worth asking your surgeon:
What is the risk of recurrence if I keep my ovaries?
How might this affect my long-term pain?
What would happen if I needed further surgery?
Because if you’re going through this operation to finally get relief from life-altering pain, the last thing you want is to end up back there again.
So… what should you do?
I know that’s what you want me to answer.
But this is one of those moments where there isn’t a universal “right” choice, only the right choice for you.
What matters is that you:
Feel informed (not rushed or pressured)
Understand both the short-term and long-term impact
Have had open conversations with your medical team
And trust your own instincts
Because you are the one who has to live in your body after this decision is made.
What the data from our community shows
At one point, I asked my TikTok community to share whether they kept their ovaries during hysterectomy, and the response was overwhelming.
Hundreds of women shared their experiences.
And while this isn’t clinical data, it is real-life insight from women who have actually lived through this decision.
Here’s what stood out:
Around 40% kept their ovaries, often because they were advised to due to their age
Around 35–40% had their ovaries removed, usually due to pain, endometriosis, cysts or cancer risk
Around 15–20% said they weren’t given a choice at all
But what I found most interesting was what happened after.
Of the women who kept their ovaries:
Around 1 in 4 said they regretted it
Many went on to have ongoing pain, cysts, or endometriosis recurrence
Some needed further surgery later to remove their ovaries anyway
Others were absolutely fine and happy with their decision, which is important to say.
But there was a clear pattern:
A lot of the regret came from women who:
were younger
had endometriosis or adenomyosis
and were advised to keep their ovaries to avoid early menopause
On the flip side, women who had their ovaries removed often spoke about:
relief from pain
peace of mind around cancer risk
but also the reality of navigating surgical menopause and HRT
What this really tells us
There isn’t a perfect choice, just different trade-offs.
Keeping your ovaries might help you avoid immediate menopause…but it doesn’t guarantee you won’t have issues later.
Removing them might reduce certain risks or symptoms…but it brings its own challenges.
And this is why this decision feels so difficult.
Because you’re not choosing between right and wrong … You’re choosing between different unknowns.
Final thoughts
If you take anything from this chapter, let it be this:
There is no easy option, only different paths.
And whichever one you choose, it doesn’t mean it was the wrong one if things don’t go perfectly.
You made the best decision you could with the information you had at the time.
And that is enough.
If you aren’t already a member of Rayse Community please join us, there is lots of us all going through the same thing
Rachel
