Beyond the Cramp: A Prospective Cohort Study on the Modulation of Premenstrual Syndrome Symptomatology Following Laparoscopic Surgery for ComorbidEndometriosis and Leiomyomas

Authors

DOI:

https://doi.org/10.54536/ajs.v1i1.6662

Keywords:

Endometriosis, Gynecology,Laparoscopic Surgery, Leiomyoma, Mood Disorders, Premenstrual Syndrome, Quality Life, Uterine Fibroids

Abstract

Premenstrual Syndrome (PMS) is a common cyclical disorder, while endometriosis and uterine leiomyomas (fibroids) are prevalent gynecological pathologies. Frequently comorbid, these conditions are typically managed for pain and bleeding. The impact of surgical treatment for endometriosis/fibroids on the broader spectrum of PMS symptoms—mood, cognition, and behavior—remains underexplored.o evaluate changes in the severity of core PMS symptoms following laparoscopic surgical intervention for endometriosis and/or leiomyomas.A single-center, prospective cohort study was conducted between October 1, 2023, and November 30, 2025. 78 premenopausal patients with moderate-to-severe PMS (diagnosed via DSM-5-TR criteria and prospective daily rating scale) scheduled for laparoscopic surgery (excision of endometriosis and/or myomectomy) were enrolled. Participants completed the Daily Record of Severity of Problems (DRSP) for two baseline cycles pre-surgery and for cycles 3-4 and 5-6 post-surgery. The primary outcome was the change in total DRSP score, with secondary analysis of mood, physical, and cognitive-behavioral subscales.65 participants completed the 6-month follow-up. A significant reduction in total DRSP score was observed at 3-4 months post-op (mean reduction: -41.2 points, 95% CI [-47.5, -34.9], p<0.001) and sustained at 5-6 months (-43.1 points [-49.8, -36.4], p<0.001). Mood subscale scores (irritability, sadness, anxiety) showed the most pronounced improvement (-52% from baseline), followed by physical symptoms. Cognitive symptoms (concentration, fatigue) also demonstrated significant, though slightly more modest, reduction. Improvement was independent of analgesia use.Laparoscopic surgical treatment for comorbid endometriosis and/or leiomyomas is associated with a significant and sustained reduction in the severity of PMS symptoms, extending far beyond pain relief. This suggests a potential shared inflammatory or neuroendocrine pathophysiology between these gynecological conditions and PMS exacerbation. Surgical management should be evaluated as a holistic intervention for the symptom complex in affected patients.

Author Biography

  • Aqsa Akram, Department of Obstetrics & Gynaecology, Fatima Memorial Hospital, Lahore, Pakistan

    My name is Dr. Aqsa Akram, and I am a triple-board–certified Obstetrician and Gynaecologist (MRCOG-UK, FACOG-USA, FCPS-Pakistan) with a strong academic foundation built on 14 Gold Medals during my MBBS and more than five years of progressive clinical experience. I currently serve as a Senior Registrar in Obstetrics & Gynaecology at Fatima Memorial Teaching Hospital, Lahore, where I lead high-risk obstetric care, advanced gynaecological procedures, and labour ward operations.
    Throughout my career, I have been deeply committed to delivering evidence-based, compassionate, and safe women’s healthcare. I have managed thousands of obstetric cases, supervised junior clinicians, and played a central role in improving labour ward protocols—contributing to reductions in severe maternal morbidity, unnecessary primary Caesarean sections, and delays in emergency surgical response times. My clinical experience ranges from complex obstetric emergencies to minimally invasive gynaecological surgery, including laparoscopic cystectomy, ectopic pregnancy management, hysterectomy, and urogynaecological procedures.
    I have always believed that a strong clinician must also be a lifelong learner. With this philosophy, I have completed more than 150 international courses, 300+ CME hours, and specialized training from leading global institutions including RCOG (UK), ACOG (USA), Stanford University, Brown University, the University of Tasmania, and the United Nations. This extensive exposure has strengthened my understanding of international standards in maternal safety, surgical excellence, and patient-centred care.
    Research and academic development hold a central place in my professional identity. I am the single author of multiple published research articles in international journals, covering themes such as maternal mental health, pre-eclampsia biomarkers, AI-based adnexal mass triage, neuro-inflammation in endometriosis, and tele-CBT for tokophobia. I have presented my work at national and international conferences and continue to expand my contributions in perinatal outcomes, maternal morbidity, and innovative models of women’s healthcare.
    I am passionate about teaching, mentoring, and shaping the next generation of clinicians. Over the years, I have supervised more than 50 postgraduate trainees and house officers, conducted weekly academic sessions, organized mock examinations, and contributed to curriculum-aligned training modules. I believe in building teams that are not only clinically sound but also empathetic and patient-centred.

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Published

2026-05-20

Issue

Vol. 1 No. 1 (2026): American Journal of Surgery

Section

Research Articles

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Copyright (c) 2026 Aqsa Akram (Author)

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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Akram, A. . (2026). Beyond the Cramp: A Prospective Cohort Study on the Modulation of Premenstrual Syndrome Symptomatology Following Laparoscopic Surgery for ComorbidEndometriosis and Leiomyomas. American Journal of Surgery, 1(1), 8-10. https://doi.org/10.54536/ajs.v1i1.6662