After one ovary is removed, the remaining ovary can usually continue releasing eggs and producing hormones. Most premenopausal women do not enter immediate surgical menopause, and pregnancy may still be possible if the remaining ovary, fallopian tube and uterus are functioning. The effect varies with age, the reason for surgery and any chemotherapy or radiotherapy.
In Hindi this is often asked as ek ovary se pregnant ho sakti hai? (क्या एक ओवरी से प्रेग्नेंट हो सकते हैं?). For many women the answer is yes, as long as the remaining ovary, a fallopian tube and the womb are healthy.
Removing one ovary is called unilateral oophorectomy. When the ovary and its fallopian tube are removed together, the operation is called unilateral salpingo-oophorectomy. This is very different from removing both ovaries, which causes surgical menopause before the natural menopause age. When the operation is for a cyst, the surgeon often tries to remove only the cyst and keep the ovary; see cystectomy and removal of an ovary.
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What Changes After One Ovary Is Removed?
The remaining ovary often compensates by continuing the monthly hormone and ovulation cycle. If the uterus is still present, periods usually continue. If the uterus was removed but one ovary remains, menstrual bleeding stops because there is no uterus, but the ovary may continue producing hormones until menopause.
Some women notice temporary changes in their cycle, hot flushes, sleep or mood during recovery. Symptoms can also result from the stress of surgery, medicines, anaemia or the condition that led to the operation. Persistent symptoms deserve review rather than assuming the remaining ovary has stopped working.
Will My Periods Continue With One Ovary?
Periods usually continue when one ovary and the uterus remain. The remaining ovary may release an egg in most cycles. It does not need to alternate perfectly from side to side, and the body does not require two ovaries to menstruate.
Periods can be irregular for a short time after surgery because of physical stress, weight change, medicines or temporary disruption of ovulation. Contact your clinician if periods remain absent, become unusually heavy, or are accompanied by persistent pain, dizziness or other concerning symptoms.
If the uterus was removed during the same operation, there will be no periods even if the remaining ovary works normally. In that situation, menopause is assessed from symptoms and, when necessary, clinical evaluation rather than bleeding patterns.
Will Removing One Ovary Cause Early Menopause?
Removing one functioning ovary does not usually cause immediate surgical menopause. The remaining ovary can continue producing oestrogen and progesterone. Some studies suggest that natural menopause may occur somewhat earlier on average after unilateral oophorectomy, but this varies widely and does not mean every woman will experience early menopause.
The likelihood of earlier ovarian failure depends on:
- age at surgery and ovarian reserve before the operation;
- health of the remaining ovary;
- endometriosis, cysts or previous ovarian surgery;
- chemotherapy or pelvic radiotherapy;
- smoking and other health factors; and
- family history of early menopause.
Possible menopause symptoms include hot flushes, night sweats, sleep disturbance, vaginal dryness, reduced libido, mood changes and missed periods. These symptoms are not specific, so persistent problems should be assessed.
Can I Become Pregnant With One Ovary?
Yes, many women conceive naturally with one ovary. Fertility depends on more than the number of ovaries. Important factors include age, egg reserve and quality, whether the remaining fallopian tube is open, sperm factors, the uterus, endometriosis and previous cancer treatment.
If the ovary and tube on one side were removed, an egg from the remaining ovary usually enters the remaining tube. Pregnancy can still occur. Fertility may be lower when the remaining ovary has disease, when ovarian reserve was already reduced, or when chemotherapy or radiotherapy has damaged eggs.
Ask for fertility advice early if:
- you plan pregnancy after cancer treatment;
- the remaining ovary has a cyst or endometriosis;
- you may need chemotherapy or pelvic radiotherapy;
- periods have stopped or become very irregular;
- you are over 35 and have not conceived after six months of trying; or
- you are younger and have not conceived after twelve months, or sooner if advised.
Tests such as anti-Müllerian hormone (AMH) and antral follicle count can estimate ovarian reserve, but they cannot guarantee natural pregnancy or predict the exact age of menopause.
If pregnancy is important to you, ask for an individual timeline rather than waiting until all follow-up is complete. The safest time to try depends on the pathology, stage, treatment received, recurrence risk and your recovery.
Do I Need Hormone Replacement After One Ovary Is Removed?
Hormone replacement therapy is not automatically required when one functioning ovary remains. Treatment is considered when symptoms and clinical assessment suggest reduced ovarian hormone production, particularly if menopause occurs at a young age.
The decision also depends on the reason for surgery. Hormone therapy may be acceptable after some gynaecological cancers and unsuitable or more complex after others. The cancer subtype, hormone-receptor information, endometriosis history, blood-clot risk and whether the uterus remains all affect the choice.
Do not start oestrogen, progesterone or over-the-counter “hormone balance” products without discussing them with the treating team after a cancer diagnosis.
What Are the Long-Term Health Effects?
A 2025 Swedish registry study compared 42,306 women who had one ovary and tube removed before age 50 with matched women who did not. Over a median follow-up of 13 years, unilateral surgery was not associated with a statistically significant increase in coronary artery disease or osteoporosis.
This is reassuring, but the study has limits:
- it was observational, so it can identify associations but cannot prove cause and effect;
- most operations were for benign ovarian disorders, benign tumours, fibroids or endometriosis;
- registry information cannot capture every lifestyle or clinical difference;
- the result does not describe every cancer-treatment pathway; and
- it should not be interpreted as proof that removing one healthy ovary is beneficial or necessary.
The study also did not find a statistically significant reduction in overall ovarian-cancer risk, although one subtype showed a lower association. Surgery should therefore be performed for a valid individual indication, not as a general cancer-prevention strategy for average-risk women.
Long-term health still benefits from regular exercise, adequate calcium and vitamin D, avoiding smoking, maintaining a healthy weight, controlling blood pressure and discussing bone-density testing when personal risk justifies it.
What Is Different When One Ovary Was Removed for Cancer?
When surgery was fertility-preserving treatment for ovarian cancer, follow-up is based on the cancer type and stage as well as reproductive goals. The advice for a benign cyst cannot be copied directly into a cancer situation.
Important questions include:
- Was the diagnosis benign, borderline or malignant?
- What was the exact histological subtype and stage?
- Was comprehensive surgical staging completed?
- Does the cancer require chemotherapy?
- Does an inherited BRCA or other cancer-risk variant change future surgery?
- When is pregnancy considered safe?
- Is removal of the remaining ovary recommended after childbearing?
For some early-stage germ-cell, sex-cord stromal or epithelial ovarian cancers, retaining the uterus and one ovary can be oncologically appropriate (see fertility-preserving cancer surgery in selected patients). Advanced epithelial ovarian cancer usually requires a different surgical approach. The pathology and stage control this decision.
How Should the Remaining Ovary Be Monitored?
There is no universal requirement for repeated ultrasound or CA-125 testing in every woman with one ovary. Monitoring depends on why the first ovary was removed, the pathology result, symptoms, family history and inherited risk.
After benign surgery, routine gynaecological care and assessment of new symptoms may be enough. After ovarian cancer or a borderline tumour, follow the surveillance schedule from the oncology team. BRCA1, BRCA2, Lynch syndrome or another inherited risk may require a separate risk-reduction plan.
A remaining ovary can still develop common cysts, endometriosis, torsion or, rarely, cancer. Routine screening ultrasound has not been shown to reliably prevent ovarian-cancer deaths in average-risk women, so testing should have a clear clinical purpose.
Which Symptoms Need Medical Assessment?
During early recovery, contact the surgical team for fever, worsening abdominal pain, persistent vomiting, wound redness or discharge, breathlessness, leg swelling, heavy bleeding or difficulty passing urine.
After recovery, arrange assessment for:
- persistent bloating or increasing abdominal size;
- new pelvic pain that does not settle;
- feeling full unusually quickly;
- new urinary urgency or frequency;
- unexplained weight loss;
- absent periods, hot flushes or vaginal dryness at a young age; or
- difficulty conceiving.
These symptoms commonly have non-cancer causes, but persistent or progressive changes should not be dismissed simply because one ovary was previously removed.
Questions to Ask at Follow-Up
- Was only the ovary removed, or the ovary and fallopian tube?
- What did the final pathology show?
- Does the remaining ovary look healthy?
- Should my periods and hormones continue normally?
- Do I need any hormone or ovarian-reserve tests?
- When can I safely try to become pregnant?
- Do I need fertility-specialist advice?
- What symptoms should lead to an ultrasound or examination?
- Do my diagnosis or family history justify genetic testing?
- What follow-up schedule applies to my pathology?
Frequently Asked Questions
Can one ovary produce enough hormones?
Usually yes. A healthy remaining ovary can often produce enough oestrogen and progesterone to maintain cycles and avoid immediate menopause.
Will I still ovulate every month?
Ovulation can continue from the remaining ovary, although no person ovulates predictably every month throughout reproductive life. The ovaries do not need to alternate.
Will removing one ovary shorten my life?
Current evidence does not show the same long-term health consequences associated with removing both ovaries before menopause. Individual risk can still be affected by the underlying disease and other treatment.
Can I go through menopause immediately after losing one ovary?
Immediate permanent surgical menopause is not expected when the remaining ovary functions. Temporary symptoms or early ovarian failure can occur and should be evaluated.
Can ovarian cancer develop in the remaining ovary?
Yes, although the individual risk depends on the original pathology and inherited risk. Having one ovary does not eliminate ovarian or related peritoneal cancer risk.
Should the other ovary be removed after I finish having children?
Not automatically. The decision depends on the original cancer or tumour, genetic results, recurrence risk, age and the health effects of early menopause.
Does removing one ovary cause weight gain?
Removing one ovary is not usually expected, by itself, to cause weight gain, because the remaining ovary normally keeps making hormones. Weight can change after any operation because of rest, less activity or changes in eating. If weight gain comes with hot flushes, missed periods or other menopause-like symptoms, mention it at follow-up so the team can check your hormones.
Is AMH a test for menopause?
AMH estimates ovarian reserve but does not diagnose menopause or predict its exact timing. Results need interpretation in the context of age, periods and treatment history.
Related Guidance and Medical Sources
Read about fertility-preserving cancer surgery, the complete ovarian-cancer treatment pathway, clear-cell ovarian cancer after surgery, or request a gynaecological cancer second opinion.