We totally understand the concerns that people have when starting HRT - especially if you have a history of reacting negatively to hormone-based treatments. However, HRT can help reduce or eliminate many of the physical risks that come in surgical menopause, and so it is strongly recommended that HRT is used where possible. If you choose not to use HRT, it needs to be an informed decision.

Several studies show that people with PMDD experience abnormal negative emotional reactions during hormone changes. However, recent studies ALSO show that these negative emotional reactions usually go away about one month after starting HRT. Therefore, if you can tolerate the symptoms in the first month following the start of HRT (or any changes in HRT), symptoms usually subside. 

So while it can be a difficult start, many people can with PMDD can take HRT during surgical menopause.  

If you’re concerned about your ability to cope with initial symptoms in the first month of HRT, we encourage you to start with a low dose and build up slowly. It is wise to be aware that this can be a difficult time of increased symptoms, and plan ahead to increase support from family, friends, and healthcare providers during this time. For example, some people are able to start HRT during a “quiet month” where there is less stress in their life. Some may also choose to see a supportive health care provider more frequently during the first month of HRT, or ask those around them to provide additional support during this time. 

Visit www.iapmd.org/surgery for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.

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