--- title: Surgical menopause: 83 studies, explained | Niyora description: 83 studies on surgical menopause and PMS or PMDD, each summarised in plain English: what was tested, who took part, what they found and what it means. url: https://niyora.com/research/topics/treatment-surgery/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Surgical menopause # Surgical menopause: what the research says 83 studies on surgical menopause in PMS and PMDD, each explained in plain English. 13 of them use the strongest designs: randomised trials and systematic reviews. Review 20 Survey study 18 Study 10 Randomised trial 8 Cohort study 6 Lab study 6 Cohort study, 2023 Do women with premenstrual disorders go through menopause earlier and have worse hot flashes? Yes. Women with premenstrual disorders went into menopause about 2.67 times earlier and were more likely to have moderate or severe hot flashes (68.3% versus 55.3%). Review, 2018 What are the most effective treatments for premenstrual syndrome and PMDD? Serotonin reuptake inhibitors and contraceptives with shortened or no hormone-free interval are the most effective treatments. Some women who do not respond may benefit from GnRH agonist treatment. Review, 2018 Which women are most likely to experience hot flashes during menopause? Up to 80% of women experience hot flashes during menopause, lasting about 10 years on average. Black and Hispanic women are more likely to experience them, while Asian women are less likely. Study, 2015 What are the different types of premenstrual problems and how should they be diagnosed? There are different types of premenstrual disorders, and doctors should use specific methods to diagnose PMS and distinguish it from other conditions. Randomised trial, 2012 Do hysterectomy or hormonal IUDs reduce premenstrual symptoms in women with heavy periods? Both treatments significantly reduced premenstrual symptoms by 6 months with similar effectiveness. However, the study involved women treated for heavy periods, not those specifically diagnosed with PMS. Survey study, 2011 Is premenstrual syndrome related to major depression? Yes. Women with moderate to severe PMS are significantly more likely to have depression (11.3% to 24.6% depending on PMS severity). Women with both conditions are more severely impaired than those with either alone. Systematic review, 2007 What treatments work for premenstrual syndrome? Many treatments have been studied for PMS, but researchers face a major challenge: there is no standard way to measure symptom severity, making it difficult to know which treatments truly work. Review, 2004 What is PMDD and how is it treated? PMDD is a severe form of PMS with physical and behavioral symptoms during the second half of the menstrual cycle. Treatment starts with lifestyle changes and over-the-counter medications, and includes antidepressants if needed. Review, 2004 How should doctors diagnose and treat PMS and PMDD? Doctors can now diagnose these conditions using specific prospective symptom tracking and have several evidence-based treatments. Antidepressants that increase serotonin, especially when taken only during the luteal phase, work best for severe symptoms. Review, 2002 What treatments work best for PMS and PMDD? Ovulation suppression and SSRIs (selective serotonin reuptake inhibitor antidepressants) are the two most effective treatments. SSRIs work particularly well for PMDD and can be taken only during the luteal phase of the cycle. Randomised trial, 1997 What is the difference between PMS and PMDD, and how should they be treated? PMDD is a severe condition distinct from PMS that can be diagnosed using standardized criteria and daily symptom tracking for at least two menstrual cycles. Treatment options include lifestyle changes, SSRIs, or surgeries that stop ovulation, all proven effective in randomized trials. Randomised trial, 1993 Does endometrial resection work as well as hysterectomy for heavy periods? Endometrial resection was almost as satisfying as hysterectomy, with 84 out of 99 women satisfied versus 89 out of 95 with hysterectomy. However, hysterectomy was better for reducing premenstrual symptoms like painful periods, bloating, and breast tenderness. Review, 1989 Are mental health conditions linked to the reproductive cycle? Psychiatric disorders like PMS and postpartum depression are linked to the menstrual cycle and pregnancy. But research on PMS is still early and many questions remain. Review, 2018 What treatments work for PMDD and severe premenstrual symptoms? This review examines evidence for many treatments including antidepressants, hormonal therapy, cognitive behavioral therapy, lifestyle changes, and herbal remedies for PMDD. The review notes that many women with severe symptoms do not meet full PMDD criteria but still benefit from treatment. Survey study, 2018 What causes irregular periods? About 14.3% of Korean women aged 19-40 have irregular periods. Stress and depressive mood are the main causes, not medical conditions. Stress is the strongest factor. Guideline, 2013 What do experts agree is the best way to treat PMS and PMDD? A group of international experts agreed that treatment should start with careful diagnosis, and that the main options work either by calming brain serotonin activity or by stopping ovulation, with some other approaches worth more study. Review, 2012 Is depression linked to hormonal changes during the menstrual cycle, pregnancy, and menopause? Yes. Depression tied to hormonal changes appears in the same women across three life stages (premenstrual, after birth, and menopause). Transdermal estrogen patches may be more effective as first-line treatment than antidepressants. Review, 2012 Does stopping ovulation help premenstrual symptoms? Yes, transdermal estrogen (patch, gel, or implant) can stop the cyclical hormone changes that cause premenstrual symptoms. However, women usually need monthly progestogen and may experience side effects. Randomised trial, 2006 Do different types of PMS symptoms respond better to different medicines? Yes. Different medications work best for different symptoms. SSRIs help irritability and anxiety. Birth control works broadly. Other drugs target specific symptoms. However, current treatments help fewer than 60% of women. Survey study, 2003 Does migraine risk change during menopause in women with PMS? Yes. In women with PMS, migraine is highest in late perimenopause at 31% and lowest after menopause at 7%. Hormone levels also affect migraine risk. Study, 2002 Does a protein called IL-6 in the uterus change throughout the menstrual cycle? Yes. IL-6 levels in the uterus are low in the first half of the cycle and increase 5 to 10 times in the second half, especially around the time for pregnancy implantation and before the period. Review, 2000 Do common diseases get worse before a woman's period? Yes. A significant number of women with asthma, arthritis, migraine, diabetes, depression, or epilepsy report that their symptoms get worse before their period, though doctors do not yet fully understand why. Survey study, 1999 How common are menstrual problems in teenage girls and do they relate to early puberty? Menstrual pain was very common (69.60%), and over half the girls (51.20%) had PMS symptoms. Girls who started menstruating earlier experienced significantly more menstrual pain. Randomised trial, 1996 What is premenstrual dysphoric disorder (PMDD) and what treatments work for it? PMDD is a severe form of premenstrual mood disturbance, separate from milder PMS, and this review reports that SSRIs and treatments that stop ovulation (hormonal or surgical) have been shown effective in placebo-controlled trials. Case-control study, 1994 Do women with a history of PMS have higher risk of osteoporosis? Women who had PMS symptoms or irregular periods in the past were more likely to develop osteoporosis after menopause. However, because women had to remember their past symptoms years later, the accuracy of these results is uncertain. Survey study, 1993 How common are period-related symptoms in Italian women, and do they differ from American women? Period-related symptoms are common in Italian women, occurring most often during the menstrual phase. Italian women reported more symptoms overall than American women, though the difference was smaller for premenstrual symptoms. Cohort study, 1993 Does rollerball endometrial ablation work for very heavy periods? Yes. Most women had much lighter periods or stopped bleeding entirely, and many experienced less period pain and fewer premenstrual symptoms. Study, 1990 How much of PMS comes from your mind versus your body? Psychological factors are important. After hysterectomy when women no longer had periods, their premenstrual symptoms dropped significantly, suggesting that psychological factors played a major role before surgery. Cohort study, 1990 Does long-term estradiol implant therapy help PMS symptoms? Yes, all 50 patients had continued benefit for all symptoms over 5.6 years, with 74 to 96 percent relief depending on the symptom. However, about 58 percent developed progestin side effects, and 8 patients needed hysterectomy. 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. Review, 2026 What causes PMDD and what treatments are available? PMDD seems to come from the body's abnormal response to hormone and brain-chemical shifts, shaped by genes, stress, immune function and opioid pathways. Several treatments exist, from SSRIs to surgery in severe cases, but this paper only summarises existing research, not a new trial. Survey study, 2023 Is the uterine fibroid symptom survey a reliable tool for measuring treatment outcomes? This study validated a survey designed to measure fibroid treatment success, but the abstract does not report whether the validation was successful. Case report, 2023 Can stopping ovulation help severe PMDD when other treatments do not work? Yes. In this case, a woman with severe PMDD symptoms had improvement when treated with leuprorelin acetate and full resolution after surgery to remove her ovaries. This is a single case of very severe PMDD. Lab study, 2022 Can we create a rat model of PMDD irritability and does treatment help? Researchers created rats with PMDD symptoms and found that two drugs reduced a brain receptor linked to the symptoms. Lab study, 2020 Can researchers create an animal model that shows depression linked to the menstrual cycle? Researchers created a rat model showing depression-like behavior during the non-receptive phase of the cycle (like the luteal phase in women) and reverse it with fluoxetine, suggesting hormonal changes cause premenstrual depression. Study, 2020 Can ozone therapy reduce PMS symptoms? In 5 women with PMS, inflammation markers decreased and infections were reduced with ozone therapy combined with diet changes. Women reported improvement. Case report, 2018 Does removing the ovaries help severe PMDD with binge eating? In one woman with severe PMDD and binge eating that hadn't improved with many treatments, removing both ovaries stopped all PMDD symptoms including the binge eating and food cravings. This is one person, so we can't know if it works for others. Review, 2018 How should doctors diagnose and treat PMDD? This review explains that PMDD needs to be carefully told apart from other mental health conditions, and that antidepressants (SSRIs and SNRIs) are the recommended first treatment, with other options available if those don't work. Interview study, 2017 What is the experience of living with PMDD and how well do doctors understand it? Women with PMDD reported severe suffering including suicidal thoughts and felt misunderstood by both doctors and family members. Interview study, 2017 What is it like to live with PMDD and how do you experience healthcare? Women with PMDD reported severe suffering including suicidal thoughts and inability to do daily tasks premenstrually. Most felt misunderstood by family and healthcare providers, and many waited a long time for diagnosis. Survey study, 2015 Does migraine increase during menopause, and can hormone therapy help? Women who had PMS before menopause are more likely to experience increased migraine during the menopausal transition. Continuous hormone replacement therapy, particularly using skin patches or gels, may help prevent hormone-related migraine attacks. Study, 2015 How are hormones related to depression in women? Depression in women is caused by hormonal changes at certain times: before periods, after birth, and around menopause. These can be effectively treated with medications or procedures that change hormone levels, especially transdermal estrogens. Review, 2015 What causes premenstrual syndrome and what is the best treatment? PMS is triggered by progesterone changes after ovulation, though the exact cause is not fully understood. Antidepressants called selective serotonin reuptake inhibitors are the most effective and recommended first-line treatment. Non-randomised trial, 2014 Does hormone therapy help women with depression linked to periods and menopause? Yes. Thirty-five percent reported being cured and 55 percent had considerable improvement. For 94 percent, hormone therapy was life-changing for the better, and none reported worsening. Study, 2012 Does stopping progesterone cause depression-like behavior? Yes. Stopping progesterone caused depression-like behavior in rats that was reduced by amitriptyline but not by fluoxetine or duloxetine. Survey study, 2012 Do women with PMDD have different ovaries or hormones than women without it? Women with PMDD had significantly fewer developing egg follicles than women without PMDD, but did not have polycystic ovaries or higher male hormones as researchers expected. Review, 2012 What causes PMS and PMDD? PMS and PMDD are triggered by hormonal changes after ovulation, but not by abnormal hormone levels. The brain's calming system (GABA) and mood system (serotonin) are both affected by progesterone changes. Review, 2012 How can doctors manage premenstrual-like symptoms caused by hormonal treatments containing progestogen? No clear evidence exists, but doctors should recognize that hormonal treatments like contraception can cause PMS-like symptoms cycling with medication use, termed progestogen-induced premenstrual disorder, and manage based on clinical experience. Case report, 2012 How can doctors tell the difference between severe PMS and bipolar disorder? Doctors can tell the difference by looking for symptoms that clearly follow the menstrual cycle and improve during pregnancy. These patterns occur in severe PMS but not in bipolar disorder, and severe PMS doesn't respond to antidepressants or mood-stabilizing medications used for bipolar disorder. Review, 2012 Should surgery be used to treat PMDD? Surgery (removing both ovaries and uterus, followed by low-dose estrogen therapy) can be effective for PMDD, but only for women who don't respond to medications or cannot tolerate them. Survey study, 2011 Do asthma symptoms get worse around menstruation? In this study of Saudi women with asthma, 8.2% had asthma symptoms that got worse around menstruation. Women with more severe asthma overall were more likely to experience this pattern. Survey study, 2010 How common are premenstrual symptoms in women around age 40? About 38% of women around age 40 had three or more premenstrual symptoms, and about 4.7% reported them as severe. Cohort study, 2007 Is vaginal hysterectomy safe when performed as same-day surgery? Yes, vaginal hysterectomy appears as safe as traditional overnight hospital stay, with 91.5 percent of women discharged within 24 hours and only 6.2 percent needing readmission. However, this research is not about PMS or PMDD. Lab study, 2007 Can antidepressants reduce anxious-like behavior during low-hormone phases in female rats? Yes. Fluoxetine, desipramine, nomifensine, diazepam, and progesterone all reduced anxious-like burying behavior during the low-hormone phase. Chlorpromazine had no effect. Randomised trial, 2006 Is PMS severity linked to how bad your migraines are? Yes, PMS and migraine severity are moderately connected. Women with migraines have worse PMS symptoms when their migraines are worse, throughout the menstrual cycle and even when hormones are surgically suppressed. Survey study, 2005 What factors are associated with having a hysterectomy in women veterans? Premenstrual syndrome was one of several factors. Women with PMS were 1.6 times more likely to have had a hysterectomy (OR 1.6, 95% CI 1.1-2.3). Other factors included older age, multiple pregnancies, and PCOS. Non-randomised trial, 2004 Is hysterectomy and ovary removal an effective treatment for severe PMS? Yes, 96% of women were satisfied with the surgery and 93.6% reported complete resolution of PMS symptoms. However, this is major surgery requiring ongoing hormone therapy and should only be considered for women with severe, treatment-resistant PMS. Lab study, 2001 Does the antidepressant fluoxetine reduce aggressive behavior during low-hormone phases in female rats? Yes. Fluoxetine at 10 mg/kg given for 4-5 days reduced aggressive behavior both during the naturally low-hormone phase and after hormone replacement in rats without ovaries. Survey study, 1998 What are women's experiences with getting diagnosed and treated for PMS by doctors? Most women took many years and saw multiple doctors before being diagnosed. Most doctors didn't use proper diagnostic tools, and only about 1 in 4 provided helpful treatment. Cohort study, 1996 Can hormones trigger PMS symptoms in women without ovaries or a uterus? Not clearly. Some individual women showed links between progesterone and symptoms, but results overall were not statistically significant. Women don't respond uniformly to hormones. Case report, 1995 Does stopping the menstrual cycle help skin conditions that get worse before periods? Yes. In this one woman, both a hormone medicine and surgery to remove her ovaries showed dramatic improvement in her skin condition. Review, 1995 What is premenstrual syndrome and how is it diagnosed and managed? Premenstrual syndrome is a real illness with physical, mental, and behavioral symptoms that occur cyclically and need treatment. Diagnosis uses symptom history, exams, and daily ratings to confirm patterns. Survey study, 1995 Does the uterus cause premenstrual symptoms? Women who had their uterus removed showed large improvements in premenstrual symptoms. This suggests the uterus may play a role, though the study cannot prove this. Survey study, 1995 Does the luteal phase of the menstrual cycle increase the risk of seclusion in female psychiatric patients? No. No clear difference was found in seclusion rates between women in the luteal phase and those in other cycle phases. Survey study, 1994 How are irritable bowel syndrome and chronic pelvic pain related? They often occur together and share similar psychological causes like depression and childhood trauma. IBS symptoms get worse during menstruation and worsen pain outcomes after surgery. Survey study, 1993 Is premenstrual syndrome a significant public health problem? According to the author, yes. Between 25 and 35 percent of women find PMS worrisome enough to need specialist care, and 5 to 10 percent experience severe symptoms. However, this is an opinion piece rather than a research study. Lab study, 1992 Does hormone withdrawal change how brain blood vessels respond to serotonin? In lab tests with rabbit blood vessel tissue, hormone withdrawal made the vessels more sensitive to serotonin. Both sudden and long-term hormone removal had this effect. Survey study, 1992 Does removing the uterus reduce PMS symptoms? Yes. Removing the uterus resulted in a 66% reduction in premenstrual symptoms. However, one woman still had mood symptoms after surgery, suggesting the uterus is not the only factor involved. Randomised trial, 1991 Does medroxyprogesterone acetate cause side effects when added to hormone therapy? No, this study found no significant physical or psychological side effects from medroxyprogesterone acetate compared to placebo, regardless of women's PMS history. Study, 1991 Do women who've had a hysterectomy still get premenstrual symptoms? Yes. Most women who have had a hysterectomy but still have ovaries continue to have cyclic mood and physical symptoms. However, symptoms clustering late in the cycle (like traditional PMS) were less common than in women who still menstruate. Survey study, 1990 Why do some women need very high hormone levels from implants? Women needing very high estrogen levels from hormone implants often have a history of depression or surgical menopause. This suggests they may require higher hormone levels to control their symptoms. Non-randomised trial, 1990 Can removing the ovaries cure severe PMS that hasn't responded to other treatments? In this small study of 14 women, yes: shutting down ovarian hormones with medication gave complete relief, and surgery to remove the ovaries and uterus (plus low-dose estrogen) gave lasting relief afterward. Study, 1990 Does removing the ovaries and uterus cure severe PMS? Yes. In this group of 14 women with severe, treatment-resistant PMS, all symptoms disappeared after surgery with continuous estrogen replacement. However, this is major surgery appropriate only for women with severe, debilitating symptoms who have failed other treatments. Cohort study, 1989 Can women without a uterus still get PMS? Yes. Three women without a uterus but with intact ovaries had PMS when tracked daily, showing that PMS is linked to ovarian hormones, not the uterus or psychological factors. Review, 1988 Are LHRH agonist drugs helpful for treating severe PMS? LHRH agonists appear beneficial for some women with severe premenstrual tension but worsen symptoms in others. They cause serious side effects like bone loss, making them unsuitable as long-term treatment for younger women. Study, 1988 Does removing the uterus stop PMS symptoms? No. One woman continued experiencing PMS symptoms even after having her uterus removed. Her mood and physical symptoms still worsened in the second half of her ovarian cycle. Review, 1987 What medicines work best for treating moderate to severe premenstrual syndrome? For mild to moderate PMS, the first approach should be diet, exercise, and nutritional supplements. For severe cases, medications like danazol, estrogen implants, or progesterone at 300 mg per day can be tried, though evidence for some is still limited. Lab study, 1987 Does the menstrual cycle change how your body's stress hormone system responds? No. Baseline stress hormone levels and the body's response to a stress hormone injection did not change across different menstrual cycle phases. Review, 1985 What medical treatments are proven effective for PMS? There is no clear evidence that any single medical treatment is definitively effective for PMS, though psychological approaches may also be worth considering. Randomised trial, 1985 What are the best methods for studying premenstrual syndrome? Good PMS research should use well-defined patient groups, confirm reports with daily monitoring, consider different types of biological changes, exclude placebo responders before testing treatments, and use double-blind placebo-controlled crossover designs. Case-control study, 1985 Do women with PMS show different hormone patterns and ovulation timing after the corpus luteum is removed? Yes. Women with PMS took longer to ovulate after corpus luteum removal (21 days versus 19 days in controls) and had lower FSH levels, suggesting their hormonal feedback system is more sensitive. Non-randomised trial, 1984 Does stopping hormone production help severe PMS? Yes. In this 6-month study of 8 women, a GnRH agonist (which stops ovarian hormone production) relieved both physical and behavioral symptoms. Long-term safety is unknown. Study, 1981 Do premenstrual tension symptoms go away after hysterectomy? No, cyclical mood and physical changes linked to the menstrual cycle continue after hysterectomy in women who had premenstrual tension syndrome, which suggests the cause is hormonal rather than related to the uterus itself. Show more studies Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗