PMS and migraines: keep ovaries or not?

I had migraines that kicked in just about the time my cycles were going to start. I couldn't control them with advil, or anything like that, but caffeine would kill the pain. It did not settle the vision problems, though. It didn't take much caffeine, but if I didn't want a soda, I'd take a No Doz.

Got rid of the ovaries & the migraines left, a few days behind them. Haven't had a migraine since September. We opted to not do HRT because I was on the pill & it jacked my blood pressure to stroke levels & my grandmother had breast cancer, although she was never on HRT after her hyst. I was afraid I would have problems, but so far, so good.

Like a lot of medical studies, they change their minds often. I heard a new report a couple of days ago, but I don't remember the details.

Hi ijewelltoo ~

During my initial visit with the GYN that is going to be performing my da Vinci surgery in March, we discussed all of my symptoms. One of my symptoms also happens to be migraines that are especially common with my PMS. One of the things my GYN asked me was, "if you could get rid of just one of the symptoms, which would you choose?" I told her by far, the heavy and unpredictable bleeding and pain. I then went on to tell her that I can survive the migraines but the bleeding is ruining my life. We both concurred that it would be a good thing to keep my ovaries, provided that they are all right -- and they will only be taken out if there is a problem once she's in there poking around. After my initial visit, my significant other and I talked at great lengths about what would be logical, what would be right for me, all of the pros and cons, and which symptoms I could live with. My physician told me that there are never any guarantees that all of my symptoms will be resolved as I could still have PMS symptoms afterward. Everyone's PMS is different. I would suggest though, writing out all of the pros and cons so that you can go over them visually to come up with what you feel is right for you.

It helped me immensely to make a pros and cons list, as well as reading the experiences of others here. Those combined helped me in making my decision and helps me keep a positive outlook on this life changing surgery. I am excited about this, and have not been this happy in a very long time.

Even though several of my biggest issues will be permanently taken care of, there are a few smaller ones that are less important on my list that I can live with.

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Originally Posted by ijewelltoo I am very afraid of the HRT news that I have found, but I am also afraid if I keep my ovaries, I will continue with the PMS, severe migraines. Any advice would be greatly appreciated. Michelle

Hi Michelle-
This is a tough decision - the same one I was faced with last summer. I was 48 and needed a hysterectomy for enlarged uterus/fibroids. I also had no signs of menopause in sight at my age, still having my periods every 28 days like clockwork. I have had severe migraines since the age of 30, but they were being managed well medicinally. My migraines occurred the week of my period and the 3 days exactly mid-cycle between my periods. I was taking 100 mg of Nortriptyline preventive daily which lessened the severity/ frequency and a Frovatriptan and Butalbital at the onset of a migraine - a lot of medication, but it kept me in the game and not debilitated by the pain.

When my daVinci surgeon (who was a new doctor to me who I had gone to for a 2nd opinion) told me I needed a hysterectomy, he told me the choice of keeping my ovaries was up to me. He had been so thorough & reassuring in everything he had told me to that point, that I felt comfortable asking him what his opinion was. He told me that for women my age, the main complaint he had from his patients who had their ovaries removed was loss of libido, which could be corrected with adjusting HRT. I told him my concerns of going on HRT with my hormonal migraine issue, and told him I thought I'd talk to my neurologist too, which he thought was a good idea. My neurologist said it really was a 50-50 shot - that some of her patients got better removing their ovaries, that some got worse. I then did a lot of reading about what our ovaries do for us, even after menopause and about all the good things they do for our heart & bone health to help us live longer. I made my decision on the following criteria:
-My libido is still very important to me and didn't want that affected.
-My severe migraines were being managed well medically, so I figured that if I left my ovaries in their status quo, I wouldn't be any worse off.
-I had trouble justifying removing my ovaries, that on ultrasound examination, appeared normal.
-I liked the health benefits we get by keeping our ovaries, even after menopause.
-And, finally, decided I would tell my surgeon that if his visual inspection on the day of surgery indicated my ovaries looked normal like they had on ultrasound, I wanted to keep them.

So I had my dvh on June 29th, w/ a very easy recovery, removing only my uterus/fibroids. Afterwards, I could tell that my ovaries were continuing to cycle normally, as I would have symptoms of a period (sore breasts, etc.). After about a month and a half, it kinda dawned on me that I hadn't had a headache/migraine since my surgery, but I figured it was just a fluke. I kept on that way until it was time for my annual PAP smear in November. I went to my new surgeon for my PAP, and when he asked how I was doing, I told him A-W-E-S-O-M-E and asked what had he done to me to make my migraines go away?? He said that sometimes when the uterus & fibroids are as enlarged as mine were, it can get your hormones "whacked out", causing things like migraines. That sometimes removing them can regulate the patient to normal levels again, as my ovaries were continuing to function.

I went back to my neurologist after that, and am now in the 4th & final month of weaning off my daily migraine preventive medication, still with no signs of migraines in sight. I am remaining hopeful that my recovery still stays on this path - no migraines - I couldn't be happier with my results.

Anyways, sorry for the long post, but you're so right - there really isn't enough info out there for us women facing this decision. It's really up to us to examine the info & assimilate it into a decision that is best for us. I just wanted to let you know you're not alone and to give you an idea of what my thought processes were in my decision. Keep asking questions and make the decision that is best for Y-O-U!!

Good luck and hope your results are as positive as mine were!!
Di

Hello Di,

Thank you for your post. I really appreciate the time and detail you put into it. Your post was very helpful. It seems we are very similar, other than I am in perimenopause.

My doctor, whom I love, believes I have a few more years left in my ovaries. The migraine issue is the only thing that was making me think I should go ahead and remove them, however after reading through everyone elses experiences, researching and weighing the pros and cons, I have decided to keep my ovaries (if they look good when the dr. gets in there).

In researching, it looks like I have all the symptoms of Estrogren deficiency. Getting this under control could assist with my migraines (i believe).

I have my pre-op appt. on 2/16, so I will ask the two pages of questions I have and hopefully feel like I am making the right decision.

Again, Thank you for your post.

Take care and wish you continued success