My Post-Hysterectomy Experience With PMS
When I decided to have a partial hysterectomy to treat and manage the symptoms associated with both endometriosis and adenomyosis, I, of course, knew that removing my uterus would, at the very least, make the monthly bleeding stop.
However, since I decided to keep both my ovaries, I wasn't sure how my PMS/PMDD symptoms would be impacted. Ovaries release and regulate hormone production.
Removing them would put me into "surgical menopause," which I didn't want to deal with. I don't do well with synthetic hormones and never have, so I didn't want to deal with HRT (Hormone Replacement Therapy).
Severe PMS symptoms
Before my hysterectomy, I got very severe PMS most months, within a week or a few days before my period. My breasts would become very swollen and tender, to the point where I used to joke they felt like balloons that had reached their capacity and were about to burst.
Often, I couldn't sleep on my stomach or side when PMSing because my breasts were so sore, and I couldn't wear some types of shirts and bras. Additionally, I would have cramps similar, or sometimes as bad, like menstrual cramps.
I would also experience an overall pain flare, where most of my body would ache as though I had mid-grade flu, and I would be extra sensitive (in a bad way) to touch. I often got terrible headaches at this time, which were often debilitating.
Sometimes I would skip a month of PMS for some reason, or it would be much less severe and shorter than usual. But most months, this is what I had and as I got older, it went from only a couple of days before I bled to a whole week or more.
PMDD symptoms
Sometimes I even had the PMS for a full two weeks. Starting in my mid-thirties, I also began to develop symptoms more resonant of PMDD (Premenstrual Dysmorphic Disorder).
PMDD is like a severe form of PMS, also abetted by dramatic mood swings. I would get irrationally angry, often feeling like I could fly into a rage over small things or I would devolve into tears at the slightest upsetting thing.
I was hoping perhaps the hysterectomy would help improve my PMS/PMDD in addition to erasing my periods.
Because though I kept my ovaries and could presumably still be cycling, removing the uterus and a bunch of endo would hopefully remove the extra estrogen that they release every month. Very high estrogen levels are sometimes associated with bad PMS/PMDD--because right before menstruation, those hormone levels drop.
If there are lower estrogen levels to drop from, perhaps the swing would hopefully not catalyze such severe symptoms.1 Much like jumping off a ledge of a few feet versus 20 feet.
Post-hysterectomy PMS symptoms
Whatever the case or reason, all I can say is nearly two years out from my hysterectomy, and my PMS/PMDD symptoms have significantly improved, to the point where the symptoms are not many (if not most) months even detectable to me. Once every few months, the symptoms will become prominent enough for me to notice (usually the telltale sign of swollen breasts) but nowhere near the severity of what I experienced pre-hysterectomy.
I may be getting symptoms without realizing it. I have chronic pain and am prone to migraines in general, but I do notice sometimes I tend to have flares about monthly, so this could be due to that.
It's hard to tell for sure, without my period letting me track where I am in my cycle (or if I am cycling on a particular month). Even if I am getting signs, it's nothing like the suffering I dealt with before.
I am not getting the abdominal cramps I used to get that mimic period cramps, so much so I called them "phantom periods." I tried to see if there were many studies to back up my experience and couldn't find much (though I didn't spend a ton of time digging).
More recent studies I could find seemed to only look at the impact of hysterectomies where the ovaries were also removed (oophorectomies). I found one study that assessed those who had hysterectomies but kept their ovaries, and all it concluded were these women still did get PMS but didn't seem to measure frequency, length, or severity of those PMS episodes.
It was also a dated study from more than 20 years ago.2 I wish more studies looked into this, as it might help women know if suffering from severe PMS/PMDD.
Have you experienced relief of PMS/PMDD symptoms since having a hysterectomy? Did you keep or remove your ovaries? Share your experience in the comments!
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