Menopause At 35 Turned My Life Upside Down
“We have your bloods back from the lab, Mrs…er…Walsh,” said the consultant at St Bart’s Hospital, London, looking up from his stack of papers and pushing his varifocals back up on the bridge of his nose. “The results are…extremely high.”
I beamed. “Oh great!”
I’d always been a reasonably studious schoolkid (I was in the A-stream at grammar school, dontcha know), so I’d come to expect no less than top marks from my body as well as my brain. Despite my loud Kentish accent, fair hair and six-foot stature, I’m no dumb blonde. So when the fertility doctor sat back in his swivel chair with a deep sigh and a furrowed brow, I was a little taken aback.
“Actually, it’s not great. Not great at all. A high FSH – that’s follicle stimulating hormone – test result is an indicator that your ovaries aren’t working as we’d expect for a woman of your age. We want a lower result. Imagine a car’s engine: you want it to purr along effortlessly, low revs. With your engine you’ve got your foot pressed hard on the accelerator, revving away…but you’re not getting anywhere….”
That was near the start of my IVF journey, back in 2009, and was the shape of things to come: one disappointment after another; tiny victories followed by crashing, crushing, blows. My previous track record of good scores and good health were eradicated within months. Instead of High Achiever I now had a new, less impressive label on my records: Poor Responder. This less-than-desirable accolade is awarded to those who, like myself, have not responded as expected to the prescribed protocol.
The drugs, put simply, didn’t work.
Oh they did do something: mood swings, hot sweats, nosebleeds in the middle of the night. But my ovaries remained stubbornly, resolutely unresponsive. The doctors increased the drug dosages incrementally, reminiscent of an executioner turning up the voltage on an electric chair and standing back, waiting for the convict’s eyes to bulge and tongue to loll out. Higher and higher they went, until they reached the maximum legal dosage. Nothing. Scan after scan, pumped full of chemicals until I was bloated and uncomfortable like a duck being force-fed for the fois gras factory. But still my ovaries refused to play ball, producing only one or two substandard eggs instead of the fifteen or so that was desired – if not required – to increase the odds of a subsequent ‘live birth.’
Time and again, the doctors shook their heads forlornly and advised cancelling the precious cycle that we’d waiting months – no, years – for…and at each appointment we pleaded with them to continue: “Because it only takes one, right?”
Eventually, my husband and I conceded defeat and acknowledged reality: we’d never have a child of our own. Not only was my body not going to produce a baby, I was about to receive another killer blow from the specialist:
Premature menopause or Premature Ovarian Failure (during which periods can still occur, as was the case for me) is the name given to menopause occurring before the age of 40. The standard age for menopause is 51. By this point, at the end of 2011, I was 35; sixteen whole years below the average age. However, it’s likely that I’d been in this sorry state for a lot longer, having had previous gynaecological surgery to remove precancerous cells following a smear test (you can read about that here) at the turn of the century in my mid-twenties, and two more operations at the start of 2008, aged 32. During the final operation I’d been advised to have my damaged fallopian tubes removed (ironically, to improve the chances of IVF success), and it was probably at this point that the blood supply to the ovaries was permanently disrupted. Surgical removal of the ovaries (oopherectomy) is the primary cause of POF, although other causes include cancer, sterilisation, trauma and stress. For some women the cause is never known.
Looking back, I had a lot of the symptoms of menopause. Yet despite this diagnosis and long, meandering gynaecological history, my GP refused to acknowledge the need for HRT (Hormone Replacement Therapy) due to the (hotly debated) health risks and instead prescribed…antidepressants. Apparently this is common, as the symptoms are similar: low mood, brain fog, fatigue, low libido. But whilst SSRIs might tackle the mood aspects of premature menopause, they do nothing to counteract the flatlining hormone levels that can have a lifelong impact on vital aspects of a woman’s health: cardiovascular disease, cancer, bone loss leading to crippling osteoporosis, tooth loss, Alzheimer’s disease and ultimately, premature death. “Really?!” I thought to myself. “Is there no end of misery in store for me?” I was at my lowest ebb, and even contemplated suicide. I was well and truly broken, both mentally and physically, as I’ve written about here.
Finally, aged 37 and having suffered years of debilitating symptoms, I saw a sympathetic private specialist who prescribed combined oral cyclical (also known as sequential) HRT: oestrogen and progesterone. It was life-changing. I threw away the antidepressants that I’d been taking for almost two years and had an immediate new lease of life. The colour was finally switched back on after a long stint in a black-and-white world. It was too late for my fertility (and sadly my marriage) yet I felt the fog slowly lifting – and with it, a glimpse of the possibility of future happiness on the horizon that had hitherto felt impossible.
If you suspect premature menopause, don’t suffer in silence.
Premature Menopause Facts:
- Premature menopause affects 1% of UK women.
- There is no cure for premature menopause or premature ovarian failure.
- Symptoms include: night sweats, disrupted sleep, mood swings, irritability, depression, low libido, weight gain and cognitive impairment (also known as ‘brain fog’).
- Pregnancy is still possible (if unlikely) during premature ovarian failure, and the woman may still be having periods. Women with POF are advised to use donor eggs during IVF, as the likelihood of IVF success with their own eggs is often as low as 5%.
- Premature menopause is often dismissed or misdiagnosed as depression. Insist on blood tests of hormone levels: FSH, LH, HCG and AMH for accurate diagnosis, taken on day 2-4 of your cycle.
- Risks of premature menopause if left untreated include cardiovascular disease, osteoporosis and low thyroid function.
- The main treatment to alleviate symptoms of menopause is HRT, although there is a slight suspected increased risk of stroke, breast cancer, ovarian cancer, womb cancer and heart disease. Benefits outweigh the risks at least upto the age of regular menopause (51).
- The different forms of hormone replacement include an oral tablet, pessaries, topical creams, gels, patches and the Mirena coil.
- Natural ways to protect health following a premature menopause diagnosis include getting plenty of calcium in the diet, exercising regularly, maintaining an ideal weight, increasing exposure to sunlight for vitamin D and bone health, stopping smoking (big tick for me on this) and reducing alcohol intake (erm, I’m still working on this one).
- Herbal alternatives include Black Cohosh, St John’s Wort, Evening Primrose Oil, Ginseng and soya products.
- If your GP is unsympathetic you are entitled to register with another doctor of your choice, not just the one in closest proximity to your address, under NHS Patient Choices guidelines.
- The Daisy Network. A patient-run support group based in UK.
- The Dovecote founded by Kelly Da Silva.
- Gateway Women founded by Jody Day.
- Premature Ovarian Failure Support Group.
- Facebook groups – plenty! Just search under Premature Ovarian Failure.
- The Non-Mum Network. A support group for women without children for whatever reason (founded by yours truly!).
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