Emma is one of a group of women with a condition called premature ovarian failure (POI) – which refers to any form of menopause before the age of 40.
Imagine you’re in your teens or twenties and discover you’re already in menopause. This is not what Emma, Soe-Myat and Elspeth imagined would happen in early adulthood.
The diagnosis was the beginning of a lonely journey to learn about a life event that all women experience as they age, but is little talked about.
It was an August morning in 2013 when a doctor told Emma Delaney that she was entering menopause at the age of 25.
Emma sat motionless in the hospital chair, her mind racing back and forth on what she was saying. Her periods, which hadn’t returned since she stopped taking the pill a few years earlier, would probably never come back. It was unlikely that she could have children naturally.
“I didn’t know how to react… He told me he couldn’t have kids, like he was saying I’d lost my keys,” she says.
Emma is among a group of women with a condition called premature ovarian failure (POI), which refers to any form of menopause before the age of 40. Most of the time, there is no known cause, and women with POIs can experience menopausal symptoms into their 50s.
Around one in 100 women in the UK are affected by the condition and experts believe it could be more common than that. But it is a topic that remains little discussed.
“There’s not enough talk about menopause in the younger age groups,” says Nighat Arif, an NHS general practitioner and TikTok star with a special interest in menopause care.
“Usually you see an older, white, gray-haired woman waving a fan. It’s not representative.”
For some women like Emma, it’s not clear why their ovaries are failing, but IOP can also be caused by autoimmune conditions, chromosomal disorders, surgery on the uterus or ovaries.
In addition to the physical consequences, the psychological impact of such a diagnosis can be devastating. After the doctor broke the news to Emma, she cried alone in the car for an hour.
Emma knew next to nothing about menopause, other than what she’d heard from older women in the busy Manchester nail salon where she works. The future she had envisioned—having and raising two children—she had been taken from her.
Over the next several months, Emma underwent hormone replacement therapy (HRT). She found that because her ovaries stopped working, her body wasn’t making enough estrogen and progesterone, the hormones that regulate the menstrual cycle. The imbalance had affected her health for years.
The mental fog she kept feeling wasn’t just part of her personality, she realized. The hot flashes that felt like fireworks exploding all over her body weren’t caused by the long hours with the hair dryer. And his sleepless nights weren’t due to insomnia: they were another symptom of a hormonal imbalance.
It didn’t help that her mother, then just 40, hadn’t yet entered menopause. Her friends were starting to get married and have children.
“It seemed like no one understood me,” she says.
Emma plunged headlong into work and avoided discussing her diagnosis. She filled her nights with ballads and chance encounters: she wanted to be the exact opposite of her friends with mates and children.
“I abused my body with alcohol and sex…I didn’t realize how much I needed to talk to someone about it,” she says.
If entering menopause prematurely wasn’t hard enough, for an increasing number of women the diagnosis comes after starting treatment for serious diseases.
For Soe-Myat Noe, a graphic design student in London, menopause was an unexpected consequence of cancer treatment. Earlier this year, at just 23, she was diagnosed with stage three bowel cancer. Radiation to her pelvic area damaged her ovaries, but she didn’t understand at the time what that would mean.
“They [médicos e enfermeiras] they just focused on my cancer and my cancer treatment… I don’t think anyone talked to me about what menopause was all about,” she says.
Her symptoms — which included ringing in her ears, anxiety and fatigue — came on suddenly and were severe. Conversations about menstruation, fertility, and menopause weren’t common when Soe-Myat was growing up, so she didn’t know what to expect. University friends, concerned about the IUD and the birth control pill, could not relate to their experience.
“Everything that was happening to me, I always associated with older people… I felt like I skipped a whole chunk of my life.”
Although Soe-Myat was able to discuss her mental health with a therapist, her physical symptoms of menopause had not been addressed. She had to fend for herself, Googling treatments while she was exhausted from chemotherapy and dealing with an ostomy bag.
While hormone replacement therapy (HRT) may not be suitable for women with certain types of cancer, there was a safe form of Soe-Myat, and once started, her symptoms improved.
She has since been released. In addition to continuing HRT, she does things on her own, like going for walks and avoiding hot drinks to help herself. But she would have liked advice on how to deal with her symptoms early in the process.
“It shouldn’t be that hard,” she says.
Dr Nighat Arif’s social media profiles are filled with messages from women who have had similar experiences. He calls for a “better understanding of the nuances” of menopause care among healthcare professionals and wants women of all ages to “break the taboo” around her.
“Please talk to the women in your life… talk to your mother, your grandmother, your aunts, your cousins, your best friend. There’s nothing to be ashamed of – learn from what they’re going through.” .”
Arif says more women are now being diagnosed with POI due to increased awareness of symptoms, but it can still be a long time before they get a diagnosis. And if left untreated, IOP can have long-term consequences for women’s bones, hearts and mental health.
“Some patients may find themselves in the dark,” he says.
“They may want to have children, and that undermines the life choices they thought they could make.”
At his clinic, Arif also sees other rarely discussed consequences of IOP, such as painful sex and loss of libido.
Elspeth Wilson, 23, understands this all too well. She was diagnosed with premature ovarian failure (POI) when she was just 15 years old. And the difficulty with sex is an obstacle that she had to face during her sexual life.
“It’s so hard to be in a relationship with someone and want to show them you love them. But your body doesn’t accept that and certain things are uncomfortable,” she says.
“What frustrates me is that the doctors never said this could be a problem.”
Elspeth has just landed her first job after university as a market researcher in Newcastle. While she commends her employer for supporting her, navigating this important transition with IOP can be challenging.
“It contributes to imposter syndrome. There will be times when I’m going to have mental fog, and that’s going to be at the worst time.”
She found solace in a WhatsApp group of other women in a similar situation. In group chat, nothing is out of the question.
“It’s comforting to just have that space to ask those questions and vent… If you have the ability to talk about it in a way that doesn’t have an ounce of shame, it’s so much easier.”
Soe-Myat, who joined an online support group for young women with cancer-induced menopause, agrees.
“I felt validated,” she says.
It’s a lesson that even Emma has learned over time.
After years of trying to block out the pain of her diagnosis, Emma has finally begun to speak more openly about her experiences. She began by explaining her feelings about her to a therapist, which helped her feel more like herself again.
“No matter my diagnosis, it was still me… I was older than my diagnosis… That was a big lesson I learned.”
A few years ago she met a partner who understands her condition and they are now living together.
On Instagram, she followed hashtags related to menopause and founded the Daisy Network, a charity set up to provide information and support to women with POIs. For the first time, she spoke to others who understood what she was going through.
Now that she’s 34, she thinks her future might include children. Egg donation and IVF would be very disruptive, she says. She therefore she is thinking of adopting in the next few years.
And, occasionally, wear a black T-shirt to the salon with the slogan “Emphasize menopause” (“Make menopause matter”, in free translation) written on the chest in red. It is covered in spots from being splashed with bleach.
Her clients will comment that she is too young to go through menopause and she will explain her situation as she touches up their roots.
“They tell me they learned more about menopause in the 30 minutes they spent with me than in their entire lives.”
“I am proud to bring information to all women.”
– This text was published in https://www.bbc.com/portuguese/geral-64109501
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Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
