Review indication for BSO

• The indication for bilateral salpingo-oophorectomy (BSO) should be checked.
• A BSO might be performed due to either benign or malignant pathology, or as part of risk reducing treatment.

MALIGNANT PATHOLOGY

• Where a BSO has been undertaken due to a prior hormone dependent malignancy, caution is required and non-hormonal alternatives should be used first line to treat any menopausal symptoms. In these individuals, if menopausal symptoms are severe or the woman is young, specialist review is recommended.

BRCA MUTATION AND RISK REDUCING SURGERY

• Women who are carriers of either the BRCA1 or BRCA2 mutations are at a higher risk of developing ovarian cancer, and may undergo removal of both ovaries and fallopian tubes for risk reducing reasons.
• For more information on prescribing HRT in these women, see assessment section.