PMS: Is there a place for removing my ovaries in the management of PMS?

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 (Q 25.8) 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 (Q 25.8).

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