Angelia Jolie has revealed that she’s had more surgery to lower her risk of cancer. In an intimate essay in The New York Times today, the Oscar-winning actress discussed the difficult decision to remove her ovaries and fallopian tubes, a procedure that put her into forced menopause at age 39.

“I will not be able to have any more children, and I expect some physical changes,” she wrote. “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.”

She said she will wear a small patch to replace estrogen and use an IUD to supply progesterone - two hormones that are reduced when the ovaries are removed. The progesterone will also help lower her risk of uterine cancer.

“I feel deeply for women for whom this moment comes very early in life, before they have had their children. Their situation is far harder than mine,” she wrote. Jolie has three biological children and three adopted children.

Angelia Jolie has revealed that she’s had more surgery to lower her risk of cancer. In an intimate essay in The New York Times today, the Oscar-winning actress discussed the difficult decision to remove her ovaries and fallopian tubes, a procedure that put her into forced menopause at age 39.

“I will not be able to have any more children, and I expect some physical changes,” she wrote. “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.”

She said she will wear a small patch to replace estrogen and use an IUD to supply progesterone - two hormones that are reduced when the ovaries are removed. The progesterone will also help lower her risk of uterine cancer.

“I feel deeply for women for whom this moment comes very early in life, before they have had their children. Their situation is far harder than mine,” she wrote. Jolie has three biological children and three adopted children.

Genes Partially Led to Decision

Jolie has a mutation in a gene called BRCA1 that makes breast and ovarian cancer much more likely for her. Her mother, grandmother, and aunt all died of cancer.

“Quite frankly I was glad to hear she had done this because the risk of the ovarian cancer conferred by her mutation and her family history,” said Mary Daly, MD, PhD, chair of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia. “I always get nervous with my patients if they keep putting off their [preventive surgery] for fear that they would have waited too long.”

Daly said having both the ovaries and fallopian tubes removed lower Jolie’s ovarian cancer risk by about 90%.

If she still had her breasts, just having the ovaries and tubes removed would have also lowered her breast cancer risk by about 50%, Daly said.

Two years ago, Jolie wrote about her decision to remove both her breasts. She knew at the time that she would eventually need further surgery to remove her ovaries, but she delayed it prepare herself “physically and emotionally” for the procedure and its consequences, she wrote.

Then a blood test revealed some troubling signs of inflammation, and she couldn’t wait any more. She had the surgery last week. Though no cancer was found, surgeons did remove a benign tumor on one of her ovaries.

“I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery,” she wrote.