Abstracts on PMS and hysterectomy
Am J Obstet Gynecol 1990 Jan;162(1):105-109
The effect of hysterectomy and bilateral oophorectomy in women with severe premenstrual syndrome.
Casper RF, Hearn MT
Department of Obstetrics and Gynecology, University of Western Ontario, London, Canada.
The etiology of premenstrual syndrome is unknown, although this syndrome is linked to the menstrual cycle. Fourteen women with severe, debilitating premenstrual syndrome volunteered for a study of therapy by hysterectomy, oophorectomy, and continuous estrogen replacement.
All had completed their families and had failed to benefit from previous medical treatment. The diagnosis and severity of premenstrual syndrome were assessed by means of prospective charting and psychological evaluation. All patients had clearly cyclic symptoms and psychological scores consistent with a major disruption of their lives before surgery.
Six months after surgery, premenstrual syndrome symptom charting revealed complete disappearance of a cyclic pattern with scores equivalent to those of a normal population. Psychological measures 6 months after operation showed dramatic improvement in mood, general affect, well-being, life satisfaction, and overall quality of life.
Surgical therapy, involving oophorectomy, hysterectomy, and continuous estrogen replacement, is effective in relieving the symptoms of premenstrual syndrome and is indicated for a small, selected group of women.
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Am J Obstet Gynecol 1990 Jan;162(1):99-105
Lasting response to ovariectomy in severe intractable premenstrual syndrome.
Casson P, Hahn PM, Van Vugt DA, Reid RL
Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada.
A total of 14 women with severe premenstrual syndrome unresponsive to conservative medical therapy were treated with danazol in doses sufficient to suppress cyclic ovarian steroidogenesis. In each case medical ovarian suppression resulted in complete relief from symptoms.
For ongoing symptom relief, each woman elected to undergo bilateral ovariectomy and concomitant hysterectomy. Both medical ovarian suppression and ovariectomy with low-dose conjugated estrogen therapy afforded lasting relief from cyclic symptoms of premenstrual syndrome and a corresponding improvement in overall quality of life.
We conclude that cyclic ovarian steroidogenesis is a powerful determinant for the expression of premenstrual symptomatology.
Ovariectomy with low-dose estrogen replacement is an effective alternative for the woman with debilitating premenstrual syndrome who does not respond to conventional interventions.
Does PMS go away after just hysterectomy alone?
I am 26 and I am considering a hysterectomy. I have very bad periods and major mood swings to the point of being so depressed I don't want to see or talk to anyone.
I have a lot of pain 2 weeks before and during. I also gain about 5 pounds.I have had my children and I don't see a need for the plumbing if it is giving me problems. Is this a good idea for me or should I wait till I'm older?
It sounds as if you are considering a hysterectomy basically because of severe PMS symptoms. It is possible, however, that there are other causes of your symptoms such as menstrual cramps due to endometriosis or adenomyosis, or chronic pelvic pain due to varicosities, etc.
I guess the first question I would ask is whether you have had a diagnostic laparoscopy to look at the pelvis and have you had any hormone therapy to suppress ovulation and menses?
These things should be done before considering hysterectomy. Secondly, if you think the main problem is PMS, has your doctor had you fill out a prospective symptom calendar to confirm that the mood changes are not present more than the two weeks premenstrual?
If we had an interactive, internet educational consultation we could better pin down whether hysterectomy is the next step for you. It really is essential to know exactly what we are treating in order to fully understand the risks and benefits of the treatment.
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