--- title: Does surgery cure PMDD that doesn't respond to medication? | Niyora description: In this one woman with severe treatment-resistant PMDD, removal of the uterus and ovaries led to long-term remission of symptoms, though she had severe depres url: https://niyora.com/research/papers/breaking-the-cycle-a-case-of-delayed-diagnosis-and-sustained-remission-following-2026/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does surgery cure PMDD that doesn't respond to medication? Case report, 2026 # Does surgery cure PMDD that doesn't respond to medication? In this one woman with severe treatment-resistant PMDD, removal of the uterus and ovaries led to long-term remission of symptoms, though she had severe depression immediately after surgery. We cannot say whether this would work for other women with PMDD. Early or limited evidence One 35-year-old woman with treatment-resistant PMDD for over two decades ## What they did This is a case report of one 35-year-old woman with treatment-resistant PMDD lasting over two decades. She had tried multiple medications without success. She was given leuprolide acetate, which confirmed her symptoms were hormone-related. She then underwent surgery to remove her uterus and both ovaries. ## What they found After surgery, the woman's PMDD symptoms stopped and have remained gone. She experienced severe depression immediately after surgery but has since recovered and remains symptom-free while taking an antidepressant and estrogen replacement. ## What it means for you This case suggests that surgery may help severe PMDD when medications fail, but the risk of depression after surgery is an important concern. This is one woman's experience, so we cannot say whether this would work for others or what other risks might occur. 35 age 2 decades duration of PMDD symptoms ## About the study Original title Breaking the Cycle: A Case of Delayed Diagnosis and Sustained Remission Following Definitive Surgical Treatment of Premenstrual Dysphoric Disorder (PMDD) Authors Deaton DJ, Deaton SL Journal Case reports in psychiatry Year 2026 Study design Case report What was tested Total hysterectomy with bilateral salpingo-oophorectomy (after leuprolide acetate trial) Open access Yes Read the paper [doi.org/10.1155/crps/8233699](https://doi.org/10.1155/crps/8233699) Original abstract Premenstrual dysphoric disorder (PMDD) is a hormone-sensitive mood disorder characterized by cyclical psychiatric and physical symptoms that impair functioning. Despite inclusion in DSM-5 and ICD-11, PMDD is frequently misdiagnosed or overlooked due to clinical unfamiliarity, lack of structured assessment, and systemic minimization of hormone-linked distress. Women routinely face delays in diagnosis and often only receive definitive treatment through self-advocacy. This report describes a 35-year-old cisgender female with treatment-resistant PMDD, whose symptoms began after menarche and worsened over two decades. Despite multiple psychiatric and medical encounters, her condition was misattributed to obesity, mood disorders, or trauma. After a diagnostic delay and multiple first and second-line treatment failures, a trial of leuprolide acetate confirmed a hormonal etiology of her symptoms, and she subsequently underwent total hysterectomy with bilateral salpingo-oophorectomy. Although she experienced a severe depressive episode in the immediate postoperative period, she has since remained in sustained symptom remission on an SSRI and estrogen replacement. This case demonstrates the need to recognize cyclic symptom patterns and potential hormonal etiology in treatment-resistant mood disorders. Reproduced under CC-BY. ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Reproductive hormone sensitivity](https://niyora.com/research/topics/condition-hormone-sensitivity/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[GnRH agonists and ovarian suppression](https://niyora.com/research/topics/treatment-gnrh/)[Surgical menopause](https://niyora.com/research/topics/treatment-surgery/)[Diagnosis experience and healthcare access](https://niyora.com/research/topics/life-area-healthcare-access/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Review, 2012 Is depression linked to hormonal changes during the menstrual cycle, pregnancy, and menopause? Non-randomised trial, 2014 Does hormone therapy help women with depression linked to periods and menopause? Review, 2018 What are the most effective treatments for premenstrual syndrome and PMDD? Review, 2004 What is PMDD and how is it treated? Review, 2004 How should doctors diagnose and treat PMS and PMDD? Review, 2002 What treatments work best for PMS and PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗