Getting hysterectomy at young age because of PMS (cont'd)
Let us assume for the sake of this writing that the diagnosis of PMS, and only that, has been confirmed. The question then becomes as to how successful hysterectomy is in curing PMS symptoms.
Also, because you are still quite young, removal of the ovaries would be very undesirable, so the question is refined to "would hysterectomy without ovary removal cure the fluid retention, mood swings, depression, and 2 weeks of pelvic pain that follow ovulation of the egg from the ovaries?"
Women who fail lifestyle changes and medical therapy for PMS often inquire about hysterectomy for PMS. They are cautioned that if the ovaries, which cause the cyclical hormonal changes, are not removed, it is very possible that the symptoms will not go away.
Some women continue to have PMS symptoms even after hysterectomy; on the other hand many women having hysterectomy note that their PMS symptoms disappear.
In some of the few studies which have evaluated hysterectomy in PMS patients, the accuracy of the PMS diagnosis suffers from a lack of prospective calendar symptom charting.
Nevertheless, hysterectomy without ovary removal seems to cure about 75% of women who have PMS (1). With well documented, refractory-to-medical-therapy PMS, removal of the ovaries along with the uterus cures close to 100% of women (2).
In other studies that look at PMS symptoms in those women who have had a hysterectomy without removing the ovaries, there seems to be a question of whether there is not some other diagnosis than PMS which is causing the symptoms.
In one study of 36 women (3) who felt they still had PMS after a hysterectomy in which the ovaries were not removed, prospective symptom charting along with hormonal assessment to detect ovulation found that:
- 25% had no PMS
- 61% had sporadic symptoms not occurring each cycle
- 14% had true PMS
This probably reflects the lack of consistent criteria to diagnose PMS but it also indicates that many times, hysterectomy without ovary removal is curative of PMS.
The bottom line is that about 25% of the time, a woman will undergo hysterectomy for what she thinks is PMS but symptoms of some sort will still persist; 75% of the time she will feel better.
As long as you understand this, you can make some choices. In general, I would suggest making sure of the accuracy of the diagnosis for which you are considering surgical therapy.