Bilateral Salpingo-Oophorectomy Overview

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Bilateral salpingo-oophorectomy, also known as a BSO, is a surgical procedure in which both of the ovaries and the fallopian tubes are removed. This surgery is usually performed during a hysterectomy, in which a woman's uterus is removed, but not always.

In contrast, when only one ovary and fallopian tube are removed, the procedure is called a unilateral salpingo-oophorectomy. It's sometimes designated as right or left with the acronym RSO (right salpingo-oophorectomy) or LSO (left salpingo-oophorectomy).


A bilateral salpingo-oophorectomy is done to treat certain types of gynecologic cancer, especially ovarian cancer. It may also be performed to prevent breast cancer and ovarian cancer in women with a strong genetic risk.

Results of This Surgery

When the ovaries are removed, women undergo immediate surgical menopause. This means that women who were pre-menopausal before surgery will be post-menopausal. Surgical menopause mimics what happens in natural menopause, when a woman's estrogen levels decline with age, due to a decline in ovarian function. It also means that a woman will not be able to have children.

This decline in estrogen commonly produces menopausal-related symptoms like hot flashes, night sweats, and vaginal dryness. The sudden drop of estrogen in the body with surgical removal of the ovaries can make the side effects of menopause more severe, as compared to the more gradual estrogen decline seen in natural menopause.

The drop in estrogen after removal of the ovaries may also increase a woman's risk of heart disease and osteoporosis, or bone loss — just as it does in natural menopause.

What Happens After Surgery?

A woman will need to follow up with her gynecologist and primary care physician after surgery to monitor health risks, like heart disease and osteoporosis, and to also determine if menopausal hormone therapy is warranted.

Menopausal hormone therapy consists of estrogen and/or progesterone, which are hormones that a woman's ovaries make. If a woman had her uterus removed with her ovaries, she can take estrogen therapy alone. On the other hand, if a woman still has her uterus, she will need progesterone therapy, in addition to estrogen. Progesterone therapy is given to prevent estrogen-mediated thickening of the uterine lining, which can cause uterine cancer.

The decision to take menopausal hormone therapy is complex and depends on a number of factors like your age, symptoms, family history, medical history, and personal needs. The dose, duration, risks, and benefits of menopausal hormone therapy must be discussed carefully with your doctor — it's a decision that is unique for each woman.

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Article Sources

  • American Cancer Society. (2015). Surgery for Ovarian Cancer.

  • The North American Menopause Society. (2014). The Menopause Practice: A Clinician’s Guide, 5th ed. Mayfield Heights, OH: The North American Menopause Society.