Occasionally, if severe problems with premenstrual syndrome persist, hysterectomy with removal of the ovaries may be the only remaining option. It is the removal of your ovaries that will abolish your cyclical symptoms of PMS and you will need oestrogen replacement therapy to prevent menopausal symptoms (HRT-hormone-replacement-therapy). If both ovaries are removed, we gynaecologists will generally recommend that the uterus is also removed. This allows the you to take oestrogen without progestogen. The majority of patients seem to opt for an oestradiol implant (Q 28.6) at the time of surgery but there is no reason why other methods of oestrogen administration (HRT-hormone-replacement-therapy) cannot be used if this is your preference.
Clearly removing the ovaries is only an option if you are absolutely certain that your family is complete. Hysterectomy may be particularly beneficial when there are other problems such as heavy or painful periods. Hysterectomy and removal of the ovaries in younger women for the relief of PMS alone is a drastic option. It should only be considered when the PMS is severely effecting your life. Suppressing the hormone levels by GnRH analogues (8) is a useful test of the likely benefits. There are two other options that should be considered before resorting to the surgical approach in younger women: the Mirena (Mirena) with oestrogen replacement or the long-term suppression of the hormone cycle with GnRH analogues in combination with HRT (8).
Related Medical Abstracts - Click on the paper title:-
Please click on the required question.
- Premenstrual Syndrome - PMS What is The Premenstrual Syndrome (PMS)
- 2 How prevalent is PMS?
- 3 How can we tell if I have PMS?
- 4 How can my PMS be evaluated?
- 5 How can cyclical breast pain (mastalgia) be treated?
- 6 How can my PMS be treated?
- 7 What is the place of progestogens and progesterone in the management of PMS?
- 8 Could suppressing my menstrual cycle reduce my PMS problems?
- 9 Could a diuretic help my PMS?
- 10 Is there a place for anti-depressants or anxiolytic drugs in the management of PMS?
- 11 Is there a place for removing my ovaries in the management of PMS?
- 12 What can be done about my decreased libido (sex drive)
- 12A What is the place of Viagra (sildenafil citrate) in sexual dysfunction in women?
- 13 How is PMS treatment monitored?
- 14 How long should PMS treatment be taken?
- 15 What is the chronic fatigue syndrome?
- 16 What is seasonal affective disorder (SAD)
- 17 Where can I obtain more information?
- 18 Support Groups.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
