Actress Angelina Jolie has revealed that she has undergone surgery to remove her ovaries and fallopian tubes, just two years after undergoing a double mastectomy.

Ms Jolie underwent the preventive double mastectomy in 2013 after a blood test revealed that she carried a mutation in her BRCA1 gene, which increased her risk of developing breast cancer by 87% and increased her risk of developing ovarian cancer by 50%.

Her mother died of ovarian cancer at the age of 56 and she also lost her grandmother and aunt to cancer.

Of her most recent surgery, she said that she had been planning it ‘for some time', and while it is a less complex procedure than a mastectomy, ‘the effects are more severe'.

"It puts a woman into forced menopause. So I was readying myself physically and emotionally, discussing options with doctors, researching alternative medicine, and mapping my hormones for estrogen or progesterone replacement. But I felt I still had months to make the date," she wrote in the New York Times.

However, two weeks ago, she received a phone call from her doctor with blood test results that revealed ‘a number of inflammatory markers that were elevated, and taken together, could be a sign of early cancer'.

She was advised to see her surgeon immediately to have her ovaries checked.

"I went through what I imagine thousands of other women have felt. 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.

"I called my husband in France, who was on a plane within hours. The beautiful thing about such moments in life is that there is so much clarity. You know what you live for and what matters. It is polarising, and it is peaceful,' she commented.

That same day, she visited the surgeon who had treated her mother, revealing that the last time she saw this doctor was the day her mother died.

An examination and ultrasound revealed no concerns and Ms Jolie then had to wait five days for further results.

"The day of the results came. The PET/CT scan looked clear, and the tumour test was negative. I was full of happiness, although the radioactive tracer meant I couldn't hug my children. There was still a chance of early stage cancer, but that was minor compared with a full-blown tumour. To my relief, I still had the option of removing my ovaries and fallopian tubes and I chose to do it," she said.

She emphasised that she did not undergo the surgery solely because of her BRCA gene mutation, adding that a positive BRCA test ‘does not mean a leap to surgery'.

She explained that she had spoken to many doctors, surgeons and naturopaths and there are ‘other options' and the most important thing ‘is to learn about the options and choose what is right for you personally'.

"In my case, the Eastern and Western doctors I met agreed that surgery to remove my tubes and ovaries was the best option, because on top of the BRCA gene, three women in my family have died from cancer. My doctors indicated I should have preventive surgery about a decade before the earliest onset of cancer in my female relatives. My mother's ovarian cancer was diagnosed when she was 49. I'm 39," she said.

She explained that she had the surgery last week and a small benign tumour was found on one ovary, but there was ‘no sign of cancer in any of the tissues'.

She pointed out that she chose to keep her womb because womb cancer is not in her family history.

She acknowledged that she cannot remove all risk and is ‘prone to cancer', but she said she will look for natural ways to strengthen her immune system.

She said that she is now in menopause and will not be able to have any more children. However she added that she feels ‘feminine and grounded' in her choices.

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

Ms Jolie added that she ‘feels deeply' for women who must face this before they have had children.

"Their situation is far harder than mine. I inquired and found out that there are options for women to remove their fallopian tubes but keep their ovaries, and so retain the ability to bear children and not go into menopause. I hope they can be aware of that."