Sarah's Story: Making the Decision to Have Her Ovaries Removed

For Sarah, having her ovaries removed was not a decision she came to lightly. She had an ovarian cyst, later confirmed as a dermoid cyst, roughly 5cm and unchanged over years of monitoring, which had been kept under review for several years prior. Whilst the cyst wasn't painful enough to stop her doing anything, she could sometimes feel it when she moved, and there were times that it would press against other areas internally causing a little discomfort.

Knowing it was there, more than the physical symptoms of it, was the most difficult part.

Sarah's mother had passed away from ovarian cancer, making the discovery of an ovarian cyst particularly worrying. Sarah, herself, had also been diagnosed with breast cancer in 2019, which had been treated with a lumpectomy, radiotherapy and hormone therapy.

From concern to understanding

"So, when that ovarian cyst started hurting a little bit or making me aware of it, that would just play on your mind a little," Sarah says. "If I got a bit of lower backache, I'd be thinking, 'What is this?'"

The cyst had initially been found in 2022, at which point Sarah was still pre-menopausal and was offered the option of having her ovaries removed. Blood tests, including CA125 levels, remained within normal limits throughout this period of monitoring. After having just beaten breast cancer and the emotional turmoil that comes with it, she decided against surgery. 

"It all felt just too much, and I was unsure," Sarah says.

Sarah describes herself as someone who likes to understand things properly before making a decision. She likes to be sure of what is going to happen, and how she is going to feel ahead of making a judgement.

"I question everything. I go deep into everything. I won't just do something without really collecting some good knowledge on it all."

As time went on, having gone through menopause, she started to think about the discussion again.

Finding the right person 

Sarah met Mrs Qureshi, a consultant gynaecologist who works at Sulis Hospital, to talk through her options and risks: conservative monitoring, expectant management or surgical removal. What she found particularly helpful during this conversation was that the discussion was not just about the cyst. Mrs Qureshi showed Sarah understanding that there was a much larger, sensitive side to this discussion.

"She really picked up more on the emotional side of it and the effect it would have on my mind and my quality of life going forward," Sarah says. "This was my concern, more than the actual cyst itself."

Still, though, Sarah wasn't immediately certain that surgery was the right thing to do. Her biggest question was what her life would be like afterwards. How would it affect her, and how would she feel?

Having your ovaries removed as a woman is hugely significant. Yes, she'd had her children and was now post-menopausal, but still, the idea of having them removed is difficult to process.

"I knew they wouldn't work anymore because of my age, but to have something removed feels like quite a leap."

Both the time and the space that Mrs Qureshi gave her were what made the difference. And eventually, Sarah decided that she was ready. She opted for a laparoscopic bilateral salpingo-oophorectomy, a keyhole procedure to remove both ovaries and fallopian tubes, alongside excision of the dermoid cyst.

The day of surgery

Sarah's surgery was a day case procedure at Sulis Hospital. Before going into theatres she chatted to the team about what she did outside of work. Sarah teaches Qigong and sound healing, and the conversation turned into a bit of fun about how different her work was from what was happening in the operating theatre.

As Sarah was put under general anaesthetic, she described her anaesthetist as gentle and soft. As if he knew exactly how she was feeling that day. When she woke up, a nurse was beside her.

"One of the guys in the theatre thought I'd be the right match for you when you come round," the nurse told her. She explained that she was also interested in energy healing.

"Somebody had gone to the trouble to go, 'You'd be a good match for this lady when she comes round.'" And whilst Sarah was still groggy from the anaesthetic, the moment stuck with her.

"It was such a lovely touch."

Seeing what had been removed

Sarah had asked Mrs Qureshi beforehand if she could take photographs during the operation. She wanted to understand what the cyst looked like and to see what had been happening inside her body.

After the operation, Mrs Qureshi came to see her and talked through what the surgery had found. Both fallopian tubes normal, surrounding organs unaffected, and the cyst removed intact, with histology later confirming it as a benign mature teratoma. It was something Sarah felt really helped the healing process begin.

"I was like, 'Oh, okay. I'm quite glad that is gone.'"

Recovery

Sarah took three weeks off work following the surgery. During that time, she used some of the practices she teaches to help with recovery. Initially, she was unable to do her usual standing Qigong practice, so she focused on other aspects of it, including breathing, movement of the hands and visualising healing.

Gradually, she returned to her normal activities. Five weeks after surgery, she travelled to the Peak District for a charity trek. She not only walked the half marathon, but alongside that, camped for two nights with her friends.

"That's when I knew I was back," she says. "I managed to do that without too much discomfort."

Before then, Sarah had noticed that if she pushed herself too hard, her body would tell her.

"If I pushed myself a little bit too hard, I did get the abdominal aches that you get when you've had abdominal surgery," she says. "The body's really good at just telling you when you're overdoing it."

Looking back

Now, Sarah says having her ovaries removed doesn't occupy her mind in the same way it once did. 

"If I get any sort of sensation or feeling in my abdomen, I know it's not my ovaries. So that's okay. I think it has just allowed me to relax and just be and minimise the risk."

Looking back, Sarah doesn't think that there was one particular moment when she suddenly knew she needed the surgery. It was more a case of asking questions, taking her time and finding someone she trusted to talk it through with.

For her, the decision has brought reassurance.