EMW06 (Alex)

Name: Alex
Age at interview: 32
Diagnosis: Medically-induced Premature Ovarian Insufficiency (POI) (following ovarian cancer treatment)
Age at diagnosis: 32

Background: Alex works part-time as a teacher and lives with her family in a metropolitan city. She is from an Australian background.

About Alex: After Alex was diagnosed with Stage 3 ovarian cancer at 32, she had a hysterectomy and surgical removal of her ovaries, chemotherapy, and then began taking an oestrogen-inhibiting medication. She began experiencing menopause symptoms after her operation, although they were ‘mixed with recovery from major surgery and chemo.’ As her cancer is hormone sensitive, Alex cannot take Hormone Replacement Therapy (HRT). The impact of premature menopause on her fertility has been particularly distressing for Alex.

More about Alex: Alex was 32 when she was diagnosed with Stage 3 ovarian cancer. Her treatment consisted of a hysterectomy and bilateral salpingo-oophorectomy (BSO) followed by chemotherapy and an oestrogen-inhibiting medication. At the time, Alex was planning to have a baby via IVF. Following her cancer diagnosis, samples of ovarian tissue were immediately extracted in an attempt to preserve her fertility but they turned out to be ‘full of cancer’ and she was unable to pursue IVF.

Alex’s oncologists and surgeons advised her that she would experience premature menopause following her surgery. She described not having the ‘emotional capacity’ to think about menopause at the time and felt she would ‘just deal with that after.’ The onset of premature menopause for Alex was ‘very sudden,’ and she felt emotionally ‘not prepared.’ Her symptoms included hot flushes, fatigue, short-term memory loss – she now ‘write[s] everything down’ – as well as nerve pain and arthritic pain.

As her type of ovarian cancer was hormone sensitive, Alex cannot take Hormone Replacement Therapy (HRT); she has not tried any non-hormonal medications. Instead she exercises to rebuild her core strength and strengthen her bones. Alex receives care from a GP, an exercise physiologist, a psycho-oncologist, an oncology naturopath and an oncology masseuse, whom she said were ‘the best support network.’

Alex described herself as a ‘mothering kind of person’ and said that having children was her ‘purpose and goal’ in life. Though she has not found her hot flushes ‘that disruptive,’ they remind her that she is ‘not a fertile 32-year-old woman anymore.’ Alex feels that it is ‘very unfair’ that she was ‘robbed’ of the chance to have children. Seeing her psycho-oncologist helps feel her ‘less isolated,’ but she finds it hard to process the ‘grief and loss’ while ‘all [her] friends’ are having families. In particular, Alex finds it ‘very distressing’ when acquaintances announce their pregnancies and has stopped following some people on social media.

Alex feels that having ovarian cancer and premature menopause makes her ‘a minority of a minority’ and wishes that she ‘could have read more experiences about young girls with menopause.’ Alex encouraged health practitioners caring for women with ovarian cancer and premature menopause to provide ‘immediate access to fertility preservation’ because ‘even an attempt is better’ than nothing. Alex now focuses on short-term goals such as getting back to work and her hobbies, and is thinking about other ways to have children, including through fostering.