The First Year After Surgery for PMDD

We often hear from people who are months/weeks (or even days!) post-op who are wondering why the surgery has not ‘fixed’ them. Surgery for PMDD is different to say, having a tumour removed. It is not a case of just removing the part, getting sewn up and you are all done. The surgery is major and you are having part of your endocrine system removed.

PMDD is a sensitivity in the brain to hormonal fluctuations. For those with PMDD, it is important to note that, although the removal of the ovaries prevents the monthly cyclical hormone fluctuations that may trigger brain reactions to hormones (e.g., emotional or cognitive changes), your brain will always be abnormally sensitive to hormones, and surgical treatment will not change that. The surgery just takes away the main source of the fluctuations (ovulation). Even those who do not have that hormonal sensitivity can really struggle to the dropping hormone levels.

You cannot have PMDD when you no longer have a menstrual cycle - but you may feel PMDD-like symptoms when you have a fluctuation. Fluctuations can be caused by various actions (both natural and also by patient actions) including (but not only): natural depletion of hormones in the body as your levels drop, changes in HRT (raising and lowering dosage), drinking alcohol, missing a dose of HRT (or in some cases, applying/administering late). Tracking your symptoms, alongside any lifestyle changes/medications, can help to give you and your provider a clearer picture.

Looking for information on thriving in surgical menopause? We have information on lifestyle, wellbeing, sexual health, lube recommendations (and what to avoid!) here:

There is no one experience of how long it takes for the hormones to ‘settle’ so they are steady and level. Some patients report finding the right HRT dosage early and keeping their levels steady. For others, it’s a longer process but it equally as ‘normal’ an experience. Since it may take quite some time to find the optimal dosages of HRT, many people with a history of hormone sensitivity still experience changes in their symptoms during this process. 

It does not mean that you still have PMDD - it just means that your brain is reacting to any fluctuations that are occurring - and some of these are out of our control whilst the body adjusts so patience is key.

It should be noted that, in the case of PMDD, there is thought to be a time lag of about 2 weeks between hormone changes and brain reactions; therefore, frequent changes to HRT levels should be avoided, and every change should be evaluated for about one month before deciding if it is effective and tolerable. Tracking can be very useful.

Patient experience: "I definitely had lots of symptoms which felt like PMDD in the first 6 months - this continued, but got gradually lesser and fewer towards the 12 month mark! Don't panic if you are having 'bumps', It is very normal'"

Looking for support from

going through (or have been through!) the same?

Check out the IAPMD - PMDD, Oophorectomy, Hysterectomy, & Life After Group

This project was financially assisted by The Patty Brisben Foundation for Women’s Sexual Health. The views expressed herein do not necessarily represent those of The Patty Brisben Foundation for Women's Sexual Health.