Life After Surgery for Premenstrual Dysphoric Disorder

The surgical management of PMDD is a last resort treatment option for good reason. Removing your ovaries permanently stops your cycling hormones and has been shown to effectively treat medication-resistant PMDD. However, it also puts you into menopause.

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Menopause itself is not a disease, but it can put you at an increased risk for certain diseases and can cause unpleasant symptoms. This is especially true when menopause happens abruptly and several years before it would have happened naturally. In other words, you will live longer without the beneficial effects of your reproductive hormones.

To help minimize the symptoms of menopause and to help prevent certain age-related conditions, it is very important that you take some form of estrogen replacement therapy after your surgery.

Protect Your Bones

Bone loss is inevitable when you enter menopause either surgically or naturally. The extra concern with entering menopause early is that you will have more years of bone loss in your lifetime. Estrogen will help slow the rapid increase in bone loss that happens in the first several years of menopause.

Weight-bearing exercise and strength training are also very important. Getting adequate calcium and Vitamin D which helps your body absorb calcium is a must! Once in menopause, the recommended daily intake of Calcium is 1,200 mg and vitamin D is at least 1,000 IU.

Watch Your Weight

Despite popular belief, menopause itself and/or estrogen replacement therapy does not cause you to gain weight.

However, it has been shown that menopause and the loss of estrogen likely causes a decrease in lean body mass and a shift in weight gain to your midsection. Having trouble buttoning your favorite pair of jeans can take a toll on your self-esteem. For some women, this may trigger disordered eating and derail fitness routines, which can eventually result in weight gain.

Menopause can also cause disruptions in your sleep. Chronic sleep deprivation increases your body’s stress hormone levels and can lead to weight gain.

If you follow a healthy diet, get adequate daily exercise, and incorporate some type of mind-body practice into your routine you will be able to maintain (or achieve) a healthy weight after surgical management of PMDD.

Know Your Heart Disease Risk

You need to know that the surgical management of PMDD is bad for your heart. Multiple studies have shown that women undergoing bilateral oophorectomy and entering menopause before age 45 are at a significantly increased risk of cardiovascular disease. The good news is that the evidence supports the use of estrogen replacement therapy to help decrease that risk.

When it comes to your heart health, it is also very important to minimize any other heart disease risk factors you may have. You will need to maintain a healthy weight and get adequate exercise. If you have high blood pressure, elevated cholesterol or diabetes it is important that you discuss this with your doctor and follow any treatment plan or medical therapy that is recommended.

Keep Your Sex Life Going Strong

Having your ovaries removed will likely have a negative impact on your sex life.

Your desire for sex is controlled in a large part by your ovarian hormones. Taking estrogen replacement and in some cases adding testosterone will help maintain your libido. Everyone's sexual response and expectations are different so it is important to discuss any concerns you have with your doctor both before and after surgery.

You also need to consider the effect of surgical menopause on your vaginal health. Without adequate estrogen, your vagina will lose its elasticity and lubrication. This causes the walls of the vagina to become thinned out and fragile. Vaginal dryness and stiffness cause sex to be painful and can result in bleeding during penetration. But don't panic; there are a few treatment options to help minimize and even prevent these very unpleasant changes in your vagina.

A Word From Verywell

Deciding on surgical management for medication-resistant PMDD is not an easy decision for many reasons. Surgery provides relief for this reproductive mood disorder but it puts you into menopause many years before the normal time. For sure, getting out from under the debilitating symptoms of PMDD will help you take better care of your overall health and wellness. Combining a healthy lifestyle and estrogen replacement will help you to live well after the surgical management of PMDD.

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  • Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, Rocca WA. Premature menopause or early menopause: long-term health consequences. Maturitas. 2010;65(2):161. doi:10.1016/j.maturitas.2009.08.003