What your describing as PMS may be the consequences of transdermal or oral hormones. There are dips and spikes with the concentration of circulating estrogens. THe more stable method, that provides a more balanced delivery is the Estradiol implant. If you're preop and using Spiro you could see a loss of energy or feel depressed because you need a small bump in testosterone. Small amounts of the male hormone will, as we see in genetic female HRT, improve mood and energy, without interfering with the feminizing effects of MtF HRT.
The ideal method is Estradiol implant and progesterone, which naturally drives down the testosterone without the need of drugs like Spiro. It's more expensive initially, but provides a more natural stable method.
Hope this helps.