Presented at the 2015 National Association for Premenstrual Dysphoric Disorder (NAPMDD) on Sunday, August 9th, 2015 by Amanda LaFleur and Melanie Cargilo.

1. Choosing Surgery: Real Life Experience and
Clinical Evidence for the Benefit of
Hysterectomy & Bilateral Salpingo-
Oophorectomy (BSO)

3. Ovulation Cycle

4. What is Progesterone?
Progesterone, also referred to as P4,
is a steroid hormone that plays a role
in the menstrual cycle, pregnancy
and the formation of embryos.

5. Recent studies show that
women with PMDD have
an increased sensitivity
to this particular
hormone and experience
increased activity in the
emotional center of the
brain.
Much like some people
drink alcohol and
become happy while
others become angry
and violent.

6. Allergy vs. Intolerance
body's immune system responds to a
substance and causes adverse health effects
(allergy)
doesn't involve an immune reaction - an
adverse effect (intolerance)

7. Progesterone Intolerance
Symptoms
depression
tiredness
loss of libido
irritability
breast discomfort
and more

8. What may work
oral contraceptives
added progesterone
SSRIs

9. What may not work
oral contraceptives
added progesterone
SSRIs

10. what will work
total hysterectomy with
removal of the cervix,
tubes, and ovaries

11. 96% of women
who underwent
a total
abdominal
hysterectomy/
bilateral
salpingo-
oophorectomy
(TAH/BSO) to
treat "severe
PMS" were
extremely
satisfied with
the results.

12. TAH/BSO
both ovaries
both tubes
cervix
womb

13. Preparing for Surgery
Research
Peer Support
Therapy
Gynecological Surgeon
Insurance
Recovery Plan

14. Types of Surgery

15. What to Expect
Lots of opinions
Fear
Uncertainty
Skepticism
Self-doubt
Excitement
Hope

16. Recovery
Nothing over 10 lbs (gallon of milk)
Laparoscopic 4-6 weeks
Abdominal 6-8 weeks
Crushing Fatigue
Adhesions
Have Patience! You only get one chance to heal.

17. Be Prepared
Plan for and ask for help
“Bumps” - PMDD like symptoms
Phantom Cycles
Mixed Emotions
Emotional Recovery

18. Layers of
Healing
physical
emotional
treating
underlying
conditions

19. Now What?
HRT
Surgical Menopause
Self Discovery
Relearning Habits
Coping Skills
Advocacy

20. “My brain and my ovaries are at war. We can’t
remove my brain”
– PMDD Survivor

21. Become a memberatnapmdd.org to
viewthe accompanyingvideo forthis
presentation.