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PMDD and Surgical Menopause


Women with PMDD often turn to Surgical Menopause as a last resort when other methods of treatment have failed to yield improvements for this condition. 


Understanding PMDD


Most women have had some form of PMS (Premenstrual Syndrome) symptom since beginning their period. Physicians feel that a good three fourths of all menstruating women experience symptoms of PMS such as painful stomach cramps, mood swings, and unusual food cravings just to name a few.


The most severe form of PMS is a condition called Premenstrual dysphoric disorder, also known as PMDD, and it occurs in roughly 3 to 5 % of all menstruating women.  Unlike PMS; which can be more easily managed and does not impact a woman’s overall quality of life, PMDD’s effects can be so crippling that it can interfere with personal  and emotional wellbeing, daily activities, work, school, and your personal relationships.


PMDD Causes:


While, as of now, there is no definitive cause for women who possess it, it is thought that PMDD may be the result of an abnormal cellular response to the hormone changes a woman experiences during the luteal phase of her menstrual cycle, such as the increase and decrease of estrogen and progesterone. Although hormone levels are normal in women with PMDD, it is the brain’s reaction to these changes in hormone levels that is abnormal.


The research that has been done to date reveals a connection between low levels of the brain chemical, serotonin, and PMDD.  Serotonin is one of the happiness hormones also know as the “feel good hormones”. Serotonin helps regulate mood, attention span, sleep as well as pain.  In women with PMDD the hormonal shifts a woman experiences at the time of her period can cause a Serotonin deficiency, resulting in crippling emotional and physical symptoms.




Women who have PMDD possess symptoms that present themselves approximately one to two weeks prior to their period and then disappear shortly after they begin bleeding. Common symptoms of PMDD are as follows:


  • Abdominal bloating

  • Breast Tenderness

  • Joint and muscle aches

  • Exhaustion or fatigue

  • Extreme mood swings

  • Decreased interest in daily activities

  • Oversensitivity to environment and people

  • Irritability

  • Increase in appetite

  • Crying

  • Unexplained anger and frustration

  • Heart palpitations

  • Hot flashes

  • Lethargy

  • Upset stomach

  • Sleep disturbances




As of yet there is no definitive test to diagnose PMDD, so health care providers diagnose this condition based on the recurrence and severity of symptoms along with the process of elimination of other health and behavioral conditions.


Medical and psychiatric evaluations are typically used in combination in order to diagnose PMDD.  This often includes a careful review of the patient’s symptoms as well as their medical history in addition to looking for any potential underlying medical issues that could be causing PMDD - like symptoms such as endometriosis, premature ovarian failure, fibroids, hormonal disorders, and menopause.




The good news is that there are several treatment options available to women with PMDD. To begin with healthy lifestyle changes are encouraged including regular exercise, yoga and meditation, as well as eating a healthy diet and taking  vitamins and supplements. On the medication front women with PMDD are often prescribed Oral Contraceptives and antidepressants also known as SSRI’s (selective serotonin re-uptake inhibitors). Additionally therapy and stress management are key to helping to treat and assist women in coping with their PMDD.


When all of the above treatment options have failed to yield helpful results, it is then as a last resort, that women desperate for relief from their PMDD symptoms should consider Surgical Menopause as an option for treatment. By removing the ovaries, or ovaries and uterus,  a woman will no longer experience the monthly fluctuations of her ovulation cycle that trigger PMDD’s problematic symptoms.


While Surgical Menopause may in fact relieve symptoms of PMDD, it is important to note (as with all women contemplating ovary removal), that Surgical Menopause should not be considered lightly. Surgical Menopause is in itself a health condition and not all women fare well or are functional with this condition.


In conclusion, while Surgical Menopause may help relieve PMDD symptoms, a woman may be left feeling equally as unwell with her symptoms from Surgical Menopause. It depends completely on the individual and how they handle surgery, along with their ability to tolerate and balance Hormone Replacement Therapy (HRT). It is a ultimately a decision that should be made with the careful consideration of your doctor and psychiatrist. 


For additional support for women struggling with PMDD and its accompanying symptoms, please seek out one of our affiliate partner foundations,  IAPMD .  




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