Hysterectomy, HRT & Panic Disorder

I am 43 years old.  I am having a hysterectomy in 10 days.  I have large fibroids in my uterus.  I get cysts on my ovaries alot.  I have a history of cervical dysplasia (4 times).  I also have pmdd and panic disorder.  About 10 weeks ago my pmdd was so bad I ended up in a psych hospital.  I did not harm or attempt to harm myself, but did have suicidal ideation and basically had a nervous breakdown in front of my therapist.  My question is: If I have both ovaries taken out, will my panic disorder get worse?  I know that pmdd goes away in the absence of the ovaries, but my concern is HRT.  Will it worsen my anxiety condition?  I take 20 mg. celexa and .50 mg klonopin bid daily.  What direction do you think we should take my HRT in if I have my ovaries removed?  At this point the oopherectomy is elective unless he finds them in bad shape.  I personally feel that my hormones are contributing to my anxiety problems.  Although I have pretty much stabilized on my current meds.  I am probably pre-menopausal, too.  Sorry this is so scattered but I need answers to many questions.

[Keith Downing, MD]

Hello,

If you have your ovaries removed, you may want to wait and see if you experience any, and to what extent you may experience, menopausal symptoms (particularly hot flushes and vaginal dryness) before deciding whether to start HRT or not.  Additionally, being on a SSRI may provide some relief of possible menopausal symptoms.  

For your bone protection, you'll want to make sure you are getting an appropriate daily requirement of Calcium (1500 mg/day) and Vitamin D (800 IU), and participate in some degree of weight bearing exercises.    

Best wishes,

Dr. Downing

[ccamrine]

What I mean about being stabilized on my meds is my panic disorder.  I still get pmdd during the luteal phase usually until menses end.  Sometimes worse than others.  Thanks in advance for your advice.