Skip to Accessibility Tools Skip to Content Skip to Footer

Fallopian Tubes: Take Them Out or Leave Them In?

I have finally reached the point in my endometriosis/adenomyosis journey where I am now ready to have a hysterectomy– probably sometime in 2019. There was a time when I was totally against the idea of having a hysterectomy in any scenario other than for cancer. As a journalist, I have often reported on the fallout of aggressive or over-prescribed surgeries, of which a hysterectomy was one.

Also, my mother had a radical hysterectomy in her early 40s when she had cervical cancer that quickly spread throughout the rest of her reproductive system. While I felt that surgery was justified due to the severity of her diagnosis, I watched the surgery quickly take its toll on my mother as she went into immediate menopause, aging decades in a matter of months following the surgery. In my mother’s case, her ovaries were also removed (which could not be avoided at the time because the cancer had already claimed them).

My next surgery

However, even though I have known what endo is since I was young, I only discovered what adenomyosis is four or five years ago, shortly before I was found to have it back in 2017. My periods have wreaked painful havoc on my life for three decades and I do not want to spend another decade or fifteen years suffering from it. Since the disease is in the very muscle of my uterus, it cannot be separated from it. So with my next laparoscopy, I have decided to take it out altogether. Yet, I do want to keep my ovaries in because I want to lower my risk of early menopause- which keeping my ovaries would do (somewhat significantly). I will also be keeping my cervix (for reasons I address in another post).

Keep the fallopian tubes?

But I am still somewhat on the fence about keeping or taking out my tubes. While I know that keeping my ovaries will likely ensure I do not go into early menopause, I have read sometimes removing the uterus -which furnishes part of the blood supply of the ovaries- can in rare cases still prompt menopause, whether temporarily (a month or two while the body adjusts) or sometimes even permanently. But some people have told me keeping the tubes, which can still leave some of that former blood supply intact, lowers those odds. If that were all there were to the issue, I would then definitely just keep them. But there’s another good reason to consider taking them out: cancer.

What the research shows: Pros

Let me elaborate: A 2017 meta-analysis published in The Journal of Minimally Invasive Gynecology revealed that removing both fallopian tubes may reduce the risk of ovarian cancer by as much as 42% to 78%.1 Why is this? It turns out that many ovarian cancers actually begin in the fallopian tubes- including those variations that tend to be the most aggressive and fatal.

Women with confirmed (that is, surgically diagnosed) endo are at an increased risk for developing ovarian cancer, particularly if they have endo on their ovaries (know as endometriomas, of which I have a moderately-sized one confirmed on my right ovary).2 However, that increased risk is not very significant and it is mostly not for the same kind of ovarian cancers taking the tubes out helps prevent. That being said, the increased risk of ovarian cancer is something to keep in mind when weighing the decision to have a hysterectomy and considering removing tubes with the uterus- especially if one has a family history of ovarian cancer or genetic testing has revealed a predisposition to developing ovarian cancer.

Cons

The downside is taking out the tubes could have hormonal consequences, even if not at the level that taking out the ovaries might. Though some studies have shown taking out the tubes for sterilization purposes mostly tend not to have significant hormonal effects, older studies of women having their tubes removed for medical reasons (such as ectopic pregnancies) did experience hormonal changes. Overall, the full range of impacts are unknown at this point and can vary, so ultimately the decision is up to the individual.

My thoughts

For me, I am personally leaning toward having my tubes taken out, though if I do, I intend to keep a close eye on my hormone levels and see if they change and if I then need to make other modifications in my medical routine to compensate (perhaps taking supplemental bio-identical hormones, etc.).

Have you had your tubes taken out? What were the effects (if any)? Or are you considering it as an option? Let us know in the comments below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Endometriosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Nezhat F, et al. Role of Minimally Invasive Surgery in Ovarian Cancer. The Journal of Minimally Invasive Gynecology. 2013;20(6):754-765. https://www.laparoscopiaginecologica.com/wp-content/uploads/2017/03/cancer-de-ovario-y-laparoscopia.pdf. Accessed June 26, 2019.
  2. Brilhante A, et al. Endometriosis and Ovarian Cancer: an Integrative Review (Endometriosis and Ovarian Cancer). Asian Pac J Cancer Prev. 2017;18(1):11-16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563086/. Accessed June 26, 2019.

Comments

  • lani06
    3 months ago

    Hi
    I had one of my endo surgeries last year and I’ve learned that you never know what you are in for when it comes down to it.
    I did end up losing both Fallopian tubes and almost lost my appendix as well.
    I did go through some hormonal issues for sure but overall it wasn’t awful. I think it was just the finalizing of knowing I will never have children of my own that made me very emotional.
    I wish you the best of luck ❤️

  • Laura Kiesel moderator author
    3 months ago

    Thank you! And thank you for sharing your experience. I am glad it wasn’t awful for you, and that makes me feel better about my own situation going in.

  • lani06
    3 months ago

    You’re welcome! Good luck! Stay strong 💪 ❤️

  • Endo Warrior moderator
    4 months ago

    Hi Laura,

    I had a hysterectomy three years ago and I opted to have my tubes, ovaries and cervix removed. I also started taking HRT soon after my surgery (which I am still taking). Keeping my ovaries was never an option for me, as I had endometriosis on my ovaries and all endometriosis had to be removed for the surgery to be successful.

    After the hysterectomy I immediately felt SO much better, like I had a new lease on life. Now, 3 years later, I still feel amazing, better than I did in my twenties and thirties. Because I take HRT, I don’t suffer from menopausal symptoms (and in fact, I have had my HRT halved in the last months and have not found that having any effect).

    I think a decision like this is very personal and you will have to decide this with your doctor, but I don’t recognise myself at all in the horror picture you paint of a woman ageing rapidly after a radical hysterectomy. If anything, I have been rejuvenated by the surgery.

    I wish you all the best.
    Christina (team member)

  • Laura Kiesel moderator author
    4 months ago

    Thanks for the input. I know other women who have done well with HRT after a radical hysterectomy. However, due to other health issues, HRT is not and will never be an option for me. And other women I’ve spoken to for whom HRT was not a viable option due to similar or the same health issues I have did suffer the effects I worry about. So, to clarify, I am worried about these potential side effects as someone who does not have HRT as an option afterwards.

  • Laura Kiesel moderator author
    4 months ago

    Also, I am very glad to hear about how much better you feel! Success stories about hysterectomies always make me feel more positive about my own decision to have one!

  • Poll