By Isabella Biedenharn
March 24, 2015 at 08:47 PM EDT
Vera Anderson/WireImage

Two years after Angelina Jolie Pitt’s preventative double masectomy and subsequent New York Times op-ed, the actress mama has undergone another preventative surgery: the removal of her ovaries and fallopian tubes. Jolie was told two years ago that she was at an 87 percent risk for breast cancer, and a 50 percent risk of ovarian cancer. With this surgery as well, Jolie has taken to the Times to explain her decision, and inform other women who might be similarly at risk of their options.

“I had been planning this for some time,” Jolie writes. “It is a less complex surgery than the masectomy, but its effects are more severe. It puts a woman into forced menopause.”  After a blood test, her doctor had informed her that she had a number of “inflammatory markers” that, taken together, “could be a sign of early cancer.”

Her husband Brad Pitt immediately flew in from France for Jolie’s consultation with a surgeon—the same one who had treated Jolie’s mother, who died of cancer. She underwent more tests, and fortunately, there was no sign of cancer. Jolie still chose to go through with the surgery, but tells other women they should choose the option that’s right for them:

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. I have spoken to many doctors, surgeons and naturopaths. There are other options. Some women take birth control pills or rely on alternative medicines combined with frequent checks.

She continues, explaining why surgery was the right choice for her.

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.

According to The Telegraph, medical experts are already applauding Jolie’s choice to go public about her decision. Two years ago, the so-called “Jolie effect” after the actress’s first op-ed triggered a substantial rise in women signing up for genetic testing to determine their own risks for cancer. 

While this surgery means she cannot have more children, Jolie concludes her op-ed with her head held high: “I will look for natural ways to strengthen my immune system. I feel feminine, and grounded in the choices I am making for myself and my family. I know my children will never have to say, ‘Mom died of ovarian cancer.'”