Do You Still Produce Estrogen After Ovaries Are Removed?

If your ovaries are removed, your body does not produce estrogen from those organs anymore. But your body still makes some estrogen in other places, just in much smaller amounts. The adrenal glands and fat tissue can convert other hormones into a small amount of estrogen after ovary removal. This is why some women still have low levels of estrogen in their blood even years after surgery.

What Happens to Estrogen Production After Ovaries Are Removed?

The ovaries are the main source of estrogen in a woman’s body. When both ovaries are removed, a surgery called bilateral oophorectomy, that primary source is gone. Estrogen levels drop sharply, often within 24 to 48 hours after surgery.

This drop is much more sudden than natural menopause. In natural menopause, estrogen declines slowly over years. After ovary removal, the drop is immediate and complete. The CDC reports that about 300,000 women in the United States have their ovaries removed each year.

Your body does not stop making estrogen entirely though. The adrenal glands, which sit on top of your kidneys, produce hormones called androgens. These androgens can be converted into estrogen by an enzyme called aromatase. Fat tissue also contains aromatase and can make small amounts of estrogen from androgens.

How Much Estrogen Does the Body Still Make After Ovaries Are Removed?

The amount of estrogen produced after ovary removal is typically very low. Research published in the Journal of Clinical Endocrinology and Metabolism has found that estrogen levels after bilateral oophorectomy are about 80 to 90 percent lower than before surgery.

For comparison, a premenopausal woman has estradiol levels between 30 and 400 picograms per milliliter depending on her cycle phase. After ovary removal, levels often fall below 10 pg/mL. This is similar to or lower than what women experience in natural postmenopause.

Some women produce more estrogen from fat tissue than others. Women with more body fat tend to have higher estrogen levels after ovary removal because fat cells convert more androgens into estrogen. This is not a large amount, but it can be enough to cause symptoms or affect health outcomes.

Age at the time of surgery also matters. Younger women may have slightly higher estrogen production from other sources because their adrenal glands are more active. But the difference is small and does not change the fact that estrogen levels remain very low.

Do You Still Produce Estrogen After Ovaries Are Removed if You Keep One Ovary?

If only one ovary is removed, the remaining ovary usually continues to produce estrogen normally. This is a very different situation from having both ovaries removed. One ovary can produce enough estrogen to maintain regular cycles and hormone levels in most women.

Some women have their ovaries removed as part of a hysterectomy. This is called a hysterectomy with bilateral salpingo-oophorectomy. In this case, the estrogen drop is the same as having ovaries removed alone. The uterus does not produce estrogen, so removing it does not affect hormone levels.

What Symptoms Occur From Low Estrogen After Ovary Removal?

The sudden drop in estrogen causes symptoms that can be more intense than natural menopause. Hot flashes and night sweats are the most common symptoms. Research shows that up to 90 percent of women who have both ovaries removed experience hot flashes within weeks of surgery.

Other symptoms include vaginal dryness, painful intercourse, and urinary urgency. Low estrogen affects the tissues of the vagina and urethra, making them thinner and less elastic. Some women report brain fog, difficulty concentrating, and memory changes.

Mood changes are also common. Estrogen affects serotonin and other brain chemicals that regulate mood. Some studies suggest that women who have both ovaries removed before age 45 have a higher risk of depression and anxiety. The North American Menopause Society notes that these mood effects are often worse in women who had a sudden surgical menopause compared to natural menopause.

Bone loss happens faster after ovary removal too. Estrogen protects bone density. Without it, women lose bone mass more rapidly. The National Osteoporosis Foundation states that women who have both ovaries removed before age 50 have a higher risk of osteoporosis and fractures later in life.

What Are the Long-Term Health Effects of Low Estrogen After Ovary Removal?

Long-term health effects depend partly on the age at which ovaries are removed. Women who have both ovaries removed before age 45 have a higher risk of heart disease, according to research published in the Journal of the American College of Cardiology. Estrogen helps keep blood vessels flexible and healthy. Without it, cardiovascular risk increases.

Cognitive decline is another concern. Some studies suggest that women who have both ovaries removed before natural menopause have a slightly higher risk of dementia later in life. The evidence is not conclusive though. A 2023 review in the journal Menopause found mixed results, with some studies showing increased risk and others showing no difference.

• Increased risk of osteoporosis and fractures
• Higher cardiovascular disease risk, especially if surgery happens before age 45
• Possible increased risk of cognitive decline, though evidence is mixed
• Higher rates of sexual dysfunction and vaginal atrophy
• Increased risk of mood disorders like depression and anxiety

Sexual health can also be affected long term. Low estrogen leads to vaginal dryness and thinning of vaginal tissues. This can make sex painful and reduce sexual desire. Some women report that these symptoms persist for years after surgery.

Not all effects are negative though. Removing the ovaries dramatically reduces the risk of ovarian cancer, which is difficult to detect early and often deadly. For women with a strong family history of ovarian cancer or BRCA gene mutations, the cancer prevention benefit often outweighs the hormone loss risks.

Can Hormone Therapy Replace Estrogen After Ovary Removal?

Hormone therapy, also called menopausal hormone therapy or estrogen therapy, can replace the estrogen your ovaries would have made. This is the most effective treatment for managing symptoms of surgical menopause. The American College of Obstetricians and Gynecologists recommends considering hormone therapy for women who have both ovaries removed before age 50.

Estrogen therapy after ovary removal can be given as a patch, gel, cream, or pill. The patch and gel are generally preferred because they deliver estrogen through the skin and do not increase blood clot risk as much as pills do. Women who still have a uterus need to take progesterone along with estrogen to prevent uterine cancer. But if the uterus was also removed, estrogen alone is safe.

Timing matters. Starting hormone therapy soon after ovary removal, ideally within a few years, provides the most benefit for bone and heart health. Waiting too long may reduce the protective effects. The North American Menopause Society states that starting hormone therapy before age 60 or within 10 years of menopause offers the best risk-benefit ratio.

Hormone therapy is not right for everyone though. Women with a history of breast cancer, blood clots, or certain types of liver disease may not be able to take estrogen. For these women, non-hormonal options like SSRIs, gabapentin, or lifestyle changes can help manage symptoms. As of 2026, there is no clinical evidence that any supplement or herbal remedy can replace estrogen as effectively as prescription hormone therapy.