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  • PMDD and hysterectomy

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    Old 09-30-2014, 03:55 PM   #1
    hannee24
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    PMDD and hysterectomy

    Hi everyone,

    Sorry in advance if this post is quite long, but I'd really appreciate some advice!

    Basically I'm 22 and have suffered from PMDD since I was 11 and it's only got worse to the extent of extreme depression. I was on Fluoxetine for 5 months which made things considerably worse and nearly ruined my final year at uni. Switched to Sertraline which is better but I still don't think it's helping. I was discharged by my psychiatrist, and I discharged myself from my psychologist because I just felt we didn't work well together so I'm looking for someone new now.

    My GP is brilliant and agreed to refer me to a gynaecologist to discuss a hysterectomy. I know I'm very young etc etc. but I've done more than enough research on the topic and I've never wanted children so that really isn't an issue for me. I've wanted my tubes tied for a long time, but when I started reading into hysterectomies with bilateral oophorectomy and how it has helped so many sufferers of PMDD, I thought that would be a far more logical option.

    So I had my gynaecology appointment last week. I obviously wasn't expecting her to instantly say "sure, let's get you booked in!", but I feel she didn't even respect my opinion and my feelings, nor did she give me the time to actually portray them. So really I just wanted some advice to see if I'm just overreacting or not.

    I stepped into the room and she said "So you have an unusual request. I'm going to say no" literally before I had even sat down, which gave me the impression that she'd made her mind up before even hearing what I had to say.

    I'd compiled a pros and cons list which I think is very comprehensive and logical - I've read case studies and journal articles and blogs of people who have been through all this. So we went through my list and her first comment was "This won't cure PMDD". I replied that I'd read countless personal experiences to the contrary and she immediately went "Is there any point in us going through this if you're just going to argue back?" ....
    She proceeded to tell me a hysterectomy won't rid me of cyclical depression. Correct me if I'm wrong, but surely if I don't have a menstrual cycle and the accompanying hormone changes, I won't have cyclical depression?

    She said that she is an advocate of psychological treatment for psychological illnesses, but PMDD isn't purely psychological... no amount of counselling is going to give me control over my hormones

    She also said my weight is concerning to her because I am slightly underweight, and I replied that that's what I've always weighed. Literally I've never been in the "normal" BMI range in my life and she went "I contest that".......

    She then told me my desire to not have children is obsessional and that if I got psychiatric help (which I have) then maybe I would learn not to rant about it, and that that shows it's purely emotional and there's no logic. I replied that if she had a woman come in and say that she was willing to try anything in order to conceive, there was no way she would tell her she was obsessional.

    This is getting super long and I could go on, but I think those are the main things that I didn't think were fair or appropriate to say to someone.
    Any advice/opinions on the matter? Am I getting too emotional about it or do you think she was out of order?

    Thanks if you can be bothered reading all of this!!

    Last edited by Administrator; 09-30-2014 at 06:26 PM.

     
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    Old 09-30-2014, 06:27 PM   #2
    sweetpotato13
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    Re: PMDD and hysterectomy

    I think she could have handled you with a TON more kindness, yet still stuck to her medical opinion about what is best for you.

     
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    Old 09-30-2014, 07:33 PM   #3
    STLouisgal
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    Re: PMDD and hysterectomy

    Your gynecologist could have handled things a little differently. But doctors take a Hippocratic Oath to "do no harm" and hysterectomy and oophorectomy are damaging surgeries since the sex organs (in men and women) have lifelong functions (far beyond reproduction) that are essential to good health and well-being. And since the damage is progressive, the younger a woman is at the time of surgery, the worse the fall-out tends to be.

    As far as depression, the post-hysterectomy hormonal changes have a good chance of causing severe depression. So instead of being cyclical, it could be constant. I have read that hysterectomies should be avoided in women who have a history of depression. I did NOT have a history of depression or any mood disorder but after my hysterectomy (at age 49), I fell into a SEVERE depression. I had a whole laundry list of other effects of the hormonal changes that threw a wrench in EVERY aspect of my life. I aged horrifically fast overnight. And no amount of hormones has completely restored my normalcy.

    The removal of my uterus and severing of those ligaments destroyed my body. I have the hysterectomy shortened, thick midsection, protruding belly, and resulting back, hip, and rib cage pain. And like you, I am underweight, always have been.

    My bowels have not worked properly since the surgery (8 years ago). Bladder problems (prolapse and incontinence) are another risk since the uterus holds the bladder in place. My vagina is like a crumpled up shirt sleeve since there is nothing holding it in place. My sex life is a big disappointment. I have no desire and very little sensation in my genitalia or breasts.

    I do know some women who had hysterectomies for PMDD and regret the trade-offs. It is human nature to seek out the positive stories oftentimes to the exclusion of the negatives especially when desperate for a solution.

    Whatever you decide, I wish you the best.

     
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    Old 09-30-2014, 08:30 PM   #4
    hannee24
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    Re: PMDD and hysterectomy

    Thank you both for your replies. I'm glad I'm not just being overly emotional about how she treated me.

    STLouisgal, I almost definitely suffer from depression already but that increases infinitely in the week before and of my period, so I think I have both depression and PMDD. I honestly don't think I could actually feel any worse emotionally after the op than I do/have done already.

    I must admit I've not read any experiences like yours - I've read quite extensively but mainly about PMDD sufferers and the only negative things they seem to say are when they haven't found the right dose of HRT for them. I'm sorry you've experienced everything you have done and I can't imagine how horrible it must be for you.

    I'm now on GnRH analogs so I'm hoping that will give me an idea of what it'd be like at least emotionally if I were to get the op. However, my gynaecologist suggested I do 6 months on, 6 months off to minimise the risk of osteoporosis and I really don't think that's a solution for me, at least not for the 6 years she said I'd have to wait for her to consider the op. 6 years is a long time to be spiralling through emotions like that, and I do enough of that naturally without having it induced by medicine.

    But I'll give GnRH some time and I would like to get at least a second opinion because I'm finding it quite hard to respect her opinion when she delivered it in the manner that she did.

    I appreciate your response though, something I'll definitely take into consideration.

     
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    Old 10-01-2014, 06:51 AM   #5
    STLouisgal
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    Re: PMDD and hysterectomy

    Interesting that she has you on GnRH analogs which are primarily used for endometriosis and fibroids. But since they shut down ovulation, that makes sense as well as the fact that they will give you a "flavor" for the effects of surgical menopause. Of course, the reason they say they should not be used for more than 6 months is due to the health risks associated with the loss of ovarian hormones. Had you already tried various birth control pills with no success? What about the recommended supplements such as calcium, magnesium, B6, and l-tryptophan?

    I hope you can get this under control.

     
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    Old 10-01-2014, 08:35 AM   #6
    hannee24
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    Re: PMDD and hysterectomy

    She gave me the impression that her "solution" would be to have me on and off GnRH analogs every 6 months for the foreseeable future and I'm still concerned about bone density loss from that. I know it's largely reversible, but it's not something I would want to be on indefinitely.

    Yeah I've tried birth control pills both on their own and in conjunction with fluoxetine and Sertraline and it hasn't eased any of my physical or emotional symptoms. I've not tried supplements but I'll definitely look into that and mention it to my doctor. Thanks!

     
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    Old 10-01-2014, 11:34 AM   #7
    STLouisgal
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    Re: PMDD and hysterectomy

    Your concerns about taking GnRH analogs have merit. Keep in mind that the adverse health effects of ovary removal are worse than taking GnRH analogs permanently. It is my understanding that GnRH analogs only shut down ovulation so the effects would be more akin to natural menopause which is much different from surgical menopause since ovaries produce hormones into a woman's 80's.

     
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