I have been very moody and emotional since my second child was born three years ago. I have had five D&Cs in the past five years. I recently heard that D&Cs can affect a woman's hormone balance, much like PMS, and can take a long time to level out. Is this true? Is there anything I can do to normalize this?

--G.W.

A D&C, a surgical procedure in which the uterine lining is curetted, or scraped, in and of itself does not cause hormone imbalance. D&Cs are usually only done to empty the uterus in case of miscarriage or elective abortion, or to diagnose and treat abnormal bleeding. Abnormal bleeding can be a sign of hormonal imbalance and a lack of consistent ovulation.

True PMS, by definition, only occurs after ovulation, in the luteal phase of the menstrual cycle. True PMS waxes and wanes, and symptoms are gone within the first day or two of menstrual flow. If moodiness and being emotional are present every day, without regard to one's cycle, then this is not PMS.

Having five D&Cs in as many years may be a sign of some type of gynecologic problem, either a hormonal problem or a structural one such as fibroids. This certainly should be evaluated by a gynecologist. The stresses involved with being a military wife, often responsible for raising two young children alone, can certainly lead to overreactiveness in daily life. While PMS or other hormonal factors may play a part, they may not be the sole culprits. Counseling may be helpful if medical causes are ruled out.