In the past, some women with premenstrual dysphoric disorder (PMDD), the severe form of PMS, had surgery to remove the ovaries (oophorectomy) and the uterus (hysterectomy). Without ovaries, a woman no longer has a menstrual cycle.
Surgical removal of the ovaries for PMDD is highly controversial and rarely done. It is only considered if a woman meets all of the following criteria:
- PMS symptoms are severe and regularly disrupt her quality of life.
- She has no future plans to give birth, and she is many years away from natural menopause.
- Symptoms improve with the use of medicines that produce a condition similar to menopause (such as danazol or a GnRH-a).
- All other treatments have failed.
- All or most of the symptoms are directly related to PMDD. Other problems, such as psychological or nonmedical problems, do not appear to contribute to the symptoms.
Removing the ovaries leads to early menopause, and the symptoms tend to be more severe than those of natural menopause. Early menopause also increases the risk of osteoporosis, because low estrogen leads to loss of bone density.
Surgery also has risks related to the procedure or anesthesia. For more information, see the topic Hysterectomy.