Angelina Jolie reveals she has had her ovaries removed over cancer scare

Two years after Angelina Jolie 39,  had a double mastectomy to prevent the onset of breast cancer, the actress has revealed that she has since had her ovaries removed due to a second health scare. 

Jolie stated that she's in menopause after having her ovaries and Fallopian tubes removed last week and will not be able to have more children.

She  published a lengthy opinion piece, titled Angelina Jolie Pitt: Diary Of A Surgery in the  New York Times on Monday, 23 March 2015 explaining her decision.

Her revelation comes as Brad Pitt was seen comforting his wife  at Shiloh and Zahara's soccer match. It's now clear the couple's affection came during Angelina's agonizing wait to establish whether she had cancer - a fear which ultimately prompted her to have surgery.  

With her ovaries and Fallopian tubes now gone, the mother-of-six has entered early menopause and will not be able to have any more children, she writes in her candid, deeply personal essay.

The mother-of-six revealed she and Brad went through an agonizing five day wait before she was given the all-clear.

In May 2013, Brad Pitt's wife famously had her breasts surgically removed after she found out she was carrying a genetic mutation that greatly increased her risk of potentially fatal breast cancer.

In the op-ed piece, Jolie explains that the mutation in the BRCA1 gene gave her an estimated 87 per cent risk of breast cancer and 50 per cent risk of ovarian cancer.

The director of Unbroken and the upcoming By The Sea, starring her newlywed husband, lost her mother, grandmother and aunt to cancer.  

According to Jolie, she had been planning to undergo surgery to remove her ovaries and Fallopian tubes for a while now, but a call from her doctor two weeks ago made the procedure more urgent. 

A blood test detected potential anomalies linked to the protein CA-125, which is used to monitor ovarian cancer, Jolie's doctor told her, urging the actress to see her surgeon, who also had treated her late mother.

'I went through what I imagine thousands of other women have felt,' she writes. 

'I told myself to stay calm, to be strong, and that I had no reason to think I wouldn't live to see my children grow up and to meet my grandchildren.'  

Brad Pitt was in France when he got the call from his wife of seven months about her new health scare, prompting him to hop on a plane and return at once to Los Angeles to be by her side.  

After undergoing a battery of tests and scans, Jolie got the good news that she was still cancer-free.

'To my relief, I still had the option of removing my ovaries and Fallopian tubes and I chose to do it,' she writes.  

Last week, Hollywood's leading lady went under the knife, undergoing what is known as a laparoscopic bilateral salpingo-oophorectomy.

Jolie revealed that one of her ovaries did have a small tumor on it but it turned out to be benign, and there were no signs of cancer in the tissues.

She noted that she chose to keep her uterus because there is no history of uterine cancer in her family.

Her mother Marcheline Bertrand died in January 2007 at the age of 56 after an eight-year battle with ovarian cancer. 

Jolie has previously spoken of the void in her life that her mother's death had left - a pain that led her to taking the brave decision to have a double mastectomy, so her children may not have to experience the pain she did.

The actress's aunt, Debbie Martin, then died of breast cancer at the age of 61 less than two weeks after Jolie revealed she had undergone her mastectomy.  

To counteract the loss of her ovaries, Jolie turned to hormone replacement therapy and had a device inserted in her womb, but she says in the essay that her child-bearing years are now behind her.

'Regardless of the hormone replacements I'm taking, I am now in menopause,' she writes. 'I will not be able to have any more children, and I expect some physical changes. But I feel at ease with whatever will come, not because I am strong but because this is a part of life. It is nothing to be feared.' 

When Jolie underwent a double mastectomy two years ago, doctors have noticed an uptick in patients electing to undergo the preventive surgery - even if they did not need it. 

On Monday, the UN envoy made it clear that her decision to have her ovaries removed was not solely based on the BRCA1 gene mutation, adding that there are other, non-surgical options out there for women, such as birth control pills, alternative treatments and frequent checks-up.

But taking into account her family's history, Jolie said undergoing the operation was the best option for her. 

'There is more than one way to deal with any health issue,' she states in the Times piece. 'The most important thing is to learn about the options and choose what is right for you personally.'

Mrs Jolie Pitt points out that surgery has not eliminated her natural predisposition for cancer, but it has taken at least one type of the deadly disease out of the equation.

'I know my children will never have to say, 'Mom died of ovarian cancer'," she writes.

Angelina Jolie has a mutation in the BRCA1 gene that gave her an estimated 87 per cent risk of breast cancer and 50 per cent risk of ovarian cancer.

Her mother died from the latter at the age of just 56.

Being a carrier of the BRCA1 or BRCA2 gene gives a woman a 45-90 per cent lifetime risk of cancer. 

These genes also increase breast cancer risk in men.

As many as 65 per cent of women who carry the BRCA1 or 2 genes will get ovarian cancer by the age of 75.

As a result of this gene mutation, Ms Jolie had her breasts surgically removed in May 2013 and has now had her ovaries removed.

The procedure, called an oophorectomy, can also reduce the risk of breast cancer in these patients by up to 50 per cent.

While the surgery has not eliminated her natural predisposition for cancer, it has taken ovarian cancer out of the equation. 

However the operation triggers menopause immediately. A woman's periods will stop after this surgery and her hormones drop quickly.

She may immediately have strong menopausal symptoms, such as hot flushes and reduced sexual desire.