Hysterectomy and bilateral oophorectomy for severe premenstrual syndrome.

Abstract

BACKGROUND:

Premenstrual syndrome (PMS) is a chronic, poorly understood psycho-endocrine disorder severely affecting 5%; of women. Hormonal therapy which suppresses ovulation is the mainstay of medical treatment, but these interventions are rarely permanent. We evaluated the effectiveness and patient satisfaction with total abdominal hysterectomy/bilateral salpingo-oophorectomy (TAH/BSO) in PMS sufferers, and assessed the post-operative HRT continuation.

METHODS:

All women undergoing TAH/BSO for severe PMS between January 1994 and April 2000 were interviewed and responses recorded by structured questionnaire.

RESULTS:

Forty-seven women were interviewed. Median age was 42 years (interquartile range 39.8-46.6) at the time of surgery. They had suffered with PMS for a mean of 9.68 years (SD 6.8) and received treatment for a mean of 3.57 years (SD 2.0) prior to referral to a gynaecologist. Fifty-two percent were treated with estradiol patches and 48% with estradiol implants prior to TAH/BSO. Ninety-six percent of women were 'satisfied' or 'very satisfied' with TAH/BSO, and 93.6% declared complete resolution of their cyclical symptoms; 93.6% were continuing with HRT usually by implants of estradiol and testosterone for a mean duration of 3.8 years (SD 1.86) post-operatively.

CONCLUSION:

Despite few reports of TAH/BSO as a treatment for severe PMS, we have found surgery, coupled with appropriate HRT, to be an extremely effective and well-accepted permanent cure for PMS.

• Authors: W H Cronje, A Vashisht, J W W Studd
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 19 Issue 9 Pg. 2152-5 (Sep 2004) ISSN: 0268-1161 [Print] England
• PMID: 15229203 (Publication Type: Journal Article)

Chemical References

• Drug Implants
• Testosterone
• Estradiol

Topics

• Administration, Cutaneous
• Adult
• Drug Implants
• Estradiol (administration & dosage, therapeutic use)
• Female
• Humans
• Hysterectomy
• Interviews as Topic
• Middle Aged
• Ovariectomy
• Patient Satisfaction
• Postoperative Care
• Premenstrual Syndrome (physiopathology, surgery)
• Severity of Illness Index
• Surveys and Questionnaires
• Testosterone (administration & dosage, therapeutic use)
• Treatment Outcome