When to remove ovaries

Why does this controversy exist and why so many ovaries are removed in women older than 45 or 50 or 55 or 60 years ?

Arguments to remove the ovaries ?

Those who remove ovaries in women older than ….. 45-50-55 use the following arguments

to prevent ovarian cancer , given the life time risk of 1/200. Moreover the diagnosis of ovarian cancer is difficult and often made too late. Ovarian cancer is a silent killer
ovaries are considered useless after menopause .

Why should we not remove the ovaries .

First women with ovaries live longer and this nothwithstanding that some of them will haven had an ovarian cancer.

Second, also after menopause the ovaries remain hormonally active and secrete androgens, which are difficult to substitute after menopause .

Times have changed : both knowledge and techniques have changed

Today we have increasingly strong arguments not to remove the ovaries

first doing so we reduce life expectancy
second removing ovaries will decrease the quality of life
in addition the newer screening techniques and the ultrasound has improved early diagnosis : thus in women with adequate medical follow-up ovaries should not be removed too liberally

Also in women with endometriosis, there are no data indicating that ovaries should be removed.
Also in women with endometriosis, there are no data indicating that ovaries should be removed.
When all surgery was performed by laparotomy ovaries were removed in order to prevent a second intervention,; this argument today is history because of the endoscopic surgery.
A non scientific argument is the observation that woman gynaecologist remove less ovaries than men.