Age at interview: 46
Diagnosis: Spontaneous Premature Ovarian Insufficiency (POI)
Age at diagnosis: 35
Background: Anna works part-time in the health sector and part-time in the arts. She lives in a regional area with her husband and their two children, and is from a European background.
About Anna: Anna was diagnosed with spontaneous premature menopause at age 35, after seeking medical advice for irregular periods and night sweats. She tried several types of Hormone Replacement Therapy (HRT) but experienced negative side-effects and eventually stopped taking the medication. Since stopping HRT, Anna has experienced hot flushes, disrupted sleep, dry skin, and anxiety. She remains concerned about her bone density but feels positive about her future.
More about Anna: When she was 32, Anna had two miscarriages while trying with her husband to have a third child. Around the same time, her periods had become irregular and she was having night sweats, prompting her to visit her GP. Initially believing Anna was depressed, her GP recommended counselling and antidepressant medication. While she ‘knew something wasn’t quite right,’ Anna was certain she wasn’t experiencing depression.
‘In the back of [her] mind’ Anna wondered if she was going through early menopause, as her grandmother had reportedly experienced menopause in her ‘mid-thirties.’ After further research, she attended a women’s health service, where a doctor ordered blood tests, ultrasounds and a bone density scan. Then aged 35, Anna was diagnosed with spontaneous premature menopause and prescribed HRT to protect her bone health, given she had low bone density in her hip and spine and a family history of osteoporosis.
For Anna, premature menopause brought a ‘real sense of loss.’ She described having the choice to have more children removed as ‘quite confronting,’ though acknowledged this would be ‘much harder’ for women who experienced premature menopause before having children.
Many of Anna’s symptoms of premature menopause, including fatigue, hot flushes, anxiety, and memory problems, were compounded by the ‘adverse effects’ she experienced while taking HRT. Although she tried several different doses and types of HRT, she found it difficult to find one that suited her and experienced ‘severe mood swings,’ ‘disrupted sleep,’ heart palpitations, and a uterine growth requiring a curette. During this time, Anna’s family also moved from the city to a regional town, where local gynaecologists were ‘extremely busy’ and difficult to book appointments with.
At age 40, Anna decided to stop HRT and ‘just take [her] chances,’ as had felt ‘worn down’ from the negative side-effects. Her menopausal symptoms returned and Anna described feeling ‘a lot older,’ but has found a healthy diet, exercise, and getting enough rest helpful in alleviating her symptoms. She hopes that calcium supplements and exercise will help her bone health. Anna also appreciates now feeling more ‘in control’ of her emotions. While taking HRT she had often felt ‘extremely irritated,’ which had affected her relationship with her husband and children.
Anna encouraged women going through early menopause to find a health practitioner who will ‘listen’ and offer different treatment options, and urged health practitioners to not disregard women’s symptoms. Anna now experiences fewer hot flushes and feels that her ‘future’s bright.’
 Use of HRT until the natural age of menopause (51 years) is recommended for women with spontaneous POI for menopausal symptoms as well as bone and heart health, unless there is a medical reason not to take oestrogen, e.g. women with personal experience of breast cancer, or who experience side-effects they cannot tolerate.