Our Summary

This research paper is all about a condition called premenstrual dysphoric disorder (PMDD), which is a severe form of premenstrual syndrome that affects a woman’s physical and mental health during a certain phase of her menstrual cycle. While the criteria to diagnose PMDD was firmly set in 2013, many women experience severe premenstrual symptoms without meeting the full criteria for PMDD. The paper also reviews various treatments for PMDD, which include therapies that target serotonin (a chemical that has a wide variety of functions in the human body), hormonal treatments, as well as lifestyle changes and herbal remedies. The paper aims to provide evidence supporting these different diagnosis and treatment methods.

FAQs

  1. What is premenstrual dysphoric disorder (PMDD)?
  2. What are the diagnostic criteria for PMDD according to the Diagnostic and Statistical Manual of Mental Disorders V?
  3. What are some of the treatment options investigated for PMDD?

Doctor’s Tip

One helpful tip a doctor might tell a patient about salpingo-oophorectomy is to discuss the potential risks and benefits of the procedure, including the impact on hormone levels and menopausal symptoms. It is important for the patient to have a thorough understanding of the potential effects on their overall health and well-being before making a decision about undergoing the surgery.

Suitable For

Patients who are typically recommended for salpingo-oophorectomy are those with a high risk of developing ovarian or fallopian tube cancer, those with a strong family history of these cancers, those with a known genetic mutation that increases the risk of these cancers (such as BRCA1 or BRCA2), and those with severe gynecological conditions such as endometriosis or pelvic inflammatory disease that have not responded to other treatments. Additionally, patients who have completed childbearing and are seeking permanent contraception may also be recommended for salpingo-oophorectomy.

Timeline

Before salpingo-oophorectomy:

  • Patient may experience severe premenstrual symptoms such as mood swings, irritability, anxiety, depression, fatigue, and physical symptoms like bloating and breast tenderness during the luteal phase of their menstrual cycle.
  • Patient may seek medical help and be diagnosed with premenstrual dysphoric disorder (PMDD) if symptoms are severe and significantly impact their daily life.
  • Treatment options may include serotonergic therapy, hormonal treatment, lifestyle changes, and herbal remedies to manage symptoms.

After salpingo-oophorectomy:

  • Patient undergoes surgical removal of one or both ovaries and fallopian tubes, known as salpingo-oophorectomy, to treat severe premenstrual symptoms or other gynecological conditions.
  • Post-surgery, patient may experience menopausal symptoms such as hot flashes, night sweats, vaginal dryness, and mood swings due to the sudden decrease in estrogen production.
  • Patient may need hormone replacement therapy (HRT) to alleviate menopausal symptoms and maintain overall health.
  • Patient may also experience emotional and psychological adjustments following the surgery and may benefit from counseling or support groups.

What to Ask Your Doctor

  1. What are the reasons for recommending a salpingo-oophorectomy?
  2. What are the potential risks and side effects of the procedure?
  3. How will the removal of the fallopian tubes and ovaries affect my hormone levels and overall health?
  4. Will I need hormone replacement therapy after the surgery?
  5. How will the surgery impact my fertility and menopausal symptoms?
  6. What is the recovery process like after a salpingo-oophorectomy?
  7. Are there any alternative treatment options that I should consider before undergoing surgery?
  8. How often will I need follow-up appointments after the procedure?
  9. What is the long-term outlook for patients who undergo a salpingo-oophorectomy?
  10. Are there any lifestyle changes or precautions I should take after the surgery to promote healing and overall health?

Reference

Authors: Appleton SM. Journal: Clin Obstet Gynecol. 2018 Mar;61(1):52-61. doi: 10.1097/GRF.0000000000000339. PMID: 29298169