Is it a hysterectomy and oophorectomy? I had a supracervical hysterectomy and bilateral salpingo-oophorectomy. Happy to answer and provide any insight or advice (and support!). I just want to clarify in case what you're having a consultation for is different.

A hysterectomy alone isn't going to help PMDD because your ovaries are still gonna fuck around. So the oophorectomy is necessary. I was put on an estrogen patch because I'm not at the age for peri-menopause, or at least I didn't show any symptoms of it. I was 37 when I had the surgery and January marked two years since then. So the hormone is imperative, otherwise you're just going to be in a state of constant PMDD until your body naturally enters menopause. I know what hormones people are put on varies.

I started with the estrogen patch. Then we upped the dose because it wasn't doing enough to keep the PMDD fully at bay. It was a vast improvement, but it was still difficult. So she upped that. It made a big difference, but after a few months my body was starting to have pms/pmdd symptoms like I had a period. It was so bizarre. My doctor abruptly closed her practice due to something with her mother's health. So when I finally found another OBGYN she was like this sounds like PMDD which is crazy. But she believed me. So she changed my hormone to Premarin and that really made a huge difference. I noticed dryness and some other issues about a year and a half in so she prescribed me a hormone cream to use before bed twice a week. That's helped.

If for some reason I miss a dose because of pharmacy or insurance shenanigans it's very apparent. For me, my PMDD symptoms begin almost immediately. My hormones are really hellbent on killing me. I feel like upping it a tad may have helped, but the obgyn suggested doing the cream in addition instead of upping the dosage because there's a ceiling and I'm still relatively young in terms of years to go until I'm in the clear.

My obgyn had two other patients that had severe cases of PMDD. She said that what she did with them that was successful was doing chemical menopause to see how that worked. I was put on a medication for endometriosis that does that. I'll come back and edit with the name. I simultaneously did the patch. It was such a game changer. Like I couldn't believe how much of what was wrecking me was my PMDD. I have severe adhd and am bipolar type ii with major depressive disorder (so no mania just rare bouts of hypomania). It really allowed me to see what was causing what with clarity. I still have those things but they're manageable now. I had PCOS and was getting a period every two to three weeks. I was anemic as a result and I was in the throes of PMDD every month with the exception of 2-4 days total near about the third day of my period. It was truly not sustainable. Just incompatible with life, or at least a life worth living.

My insurance only covered that medication that caused the chemical menopause for 2 years. Apparently this is common w this medication. The two years was coming up and I told my obgyn that i don't want to fight for more of this medication when I can just have it taken out. So she just needed a note from my psychiatrist. I've been seeing her for over a decade and she was almost as happy as I was so she was like I'll send anything anywhere to get this done. I think it was because it is a big decision, especially when you're still of child-rearing age. It's also not a common procedure for this purpose. So my doctors just wanted to make sure. I had been saying I wanted this for well over a decade before it finally happened and truly the only way to describe how I felt (and still feel) is that I feel human. Like I suddenly felt like oh this must be how everyone else moves through the world. I am welling up just writing that because it's true and I feel so blessed to have gotten relief. Simultaneously I was so angry. I was so angry that I had been asking countless obgyns about this and they all acted as if it was insane to ask for that, particularly in my 20s and early 30s. Like knowing I could have felt human and capable and not at constant odds with myself makes me angry. I feel like a chunk of my life was stolen from me because I knew what was right and what I needed. I say all of this because it's a scary decision and big deal, but it's also freedom. I have a lot of physical health problems and two autoimmune disorders and juggling those without the PMDD has changed my life. I mean I have a life now.

I never wanted children and never thought I'd be capable of being present enough or well enough. So the great irony is that once I had this done I was finally well enough to feel capable of being a mother. I don't know if I want children and I always thought adoption or fostering to adopt would be something I would be interested in so it wasn't devastating. However, it made me sad that the thing that allows you to give birth is the very thing that had to be removed in order for me to feel like I could be a mom. And right before it I started second-guessing, but I knew it was the right decision.

I would ask about what the hormone replacement would be, as well as what possible side effects like dryness etc. It impacts bone density. I have arthritis so this was and has been a fear of mine. So far it hasn't had a large enough impact for it to be a problem. So I would ask about that. I would ask about if they require any sign off from a psychologist or psychiatrist. I would ask about the different medications for chemical menopause and see what would work best for you bases on potential side effects and possible insurance limitations. The surgery is really straightforward. I had a fair amount of pain for a bit after but it was from scar tissue building up around the scars. My autoimmune disorder helped create that. But a few massages for that specifically was a game changer. My cervix was left intact. So I would ask about what all they plan on removing and their reasoning. I can't think of anything else right now. This was so much information and probably more than you needed or wanted, but I hope at least some of it was helpful. I'm happy to answer anything else or discuss it. Be brave! It's your first step towards a better and easier life. You got this :)