Progestogen therapy immediately begins to prevent estrogen-related overgrowth of the uterine lining.

However, temporary side effects after starting these medications can sometimes take several months to dissipate (although some can be persistent). We recommend tracking your symptoms and side effects daily (or at least weekly) in order to have a clear visual of how symptoms are responding, and whether side effects are decreasing over time. It is also a good idea to track any menstrual bleeding, as this may be useful to your doctor when deciding how to proceed.

Similarly, any changes made to your therapy route, dosage or frequency should be evaluated using daily ratings so that the pattern of change can be monitored objectively. We recommend waiting at least one full month on the new therapy before evaluating the new treatment or making any additional changes, since effectiveness and side effects may fluctuate prior to stabilizing again on the new treatment.

This is particularly important for those who have an emotional hormone sensitivity; studies suggest that any change in hormone levels can provoke symptoms among those patients, but that those symptoms go away again after one month of the new therapy. Therefore, patience and support are needed to evaluate the “true” effects of any treatment change.
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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.