EMW02 (Fiona)

Name: Fiona
Age at interview: 45
Diagnosis: Medically-induced early menopause (following breast cancer treatment and a risk-reducing bilateral oophorectomy)
Age at diagnosis: 41

Background: Fiona is a volunteer and former business owner. She is married with two children, and lives in a metropolitan city. Fiona is from an Australian / English background.

About Fiona: Fiona experienced early menopause after having her ovaries and fallopian tubes removed at age 41, an operation she underwent to reduce the chances of her hormone sensitive breast cancer coming back. Prior to this, Fiona had experienced temporary menopausal symptoms as a result of chemotherapy, radiotherapy, and adjuvant endocrine therapy (tamoxifen) to minimize oestrogen production. Early menopause has been ‘stressful’ for Fiona, but she feels ‘lucky’ to be alive.

More about Fiona: When Fiona was 39, she was diagnosed with ‘highly aggressive’ Stage 3C hormone sensitive breast cancer and underwent a mastectomy a week later. After recovering from the surgery, she started chemotherapy, which caused her menstrual period to stop and brought on menopausal symptoms, including hot flushes. Fiona then had radiotherapy, and began taking tamoxifen to reduce the chance of her cancer returning.

After a friend passed away from ovarian cancer secondary to breast cancer, Fiona decided to have her ovaries removed via a bilateral salpingo-oophorectomy (BSO) to further reduce the risk of her cancer coming back. She and her husband had not planned to have any more children, which made the decision to have a BSO easier. The surgery put Fiona into early menopause, and her doctor then replaced her prescription of tamoxifen with anastrozole, an oestrogen-suppressing medication for postmenopausal women.

Due to cancer treatment and early menopause, Fiona experienced nerve pain in her feet, facial hair, arthritis, loss of libido, and difficulties with ‘temperature control.’ She was also aware that early menopause would reduce her bone density and impact on her cardiovascular health. To deal with these symptoms and the long-term effects of early menopause, Fiona carried a hand fan for hot flushes, dressed in layers and wore sandals to accommodate changes in her body temperature, had her face waxed when needed, did light exercise to increase her strength and fitness, and took calcium and vitamin D supplements for bone health. She has bone density scans every two years.

Fiona read widely about breast cancer and early menopause online, and talked with health practitioners, other women with breast cancer, and ‘anybody who was menopausal.’ She described herself as ‘proactive’ in her discussions with her doctors.

Although Fiona felt that early menopause was ‘nothing’ compared with breast cancer treatment, she said it was still ‘stressful’ as sometimes it had been difficult to know if her symptoms were menopause-related or a sign of cancer coming back. The combination of cancer treatment and early menopause also made her feel as though at 39, ‘instead of turning 40 [she’d] almost turned 80.’ Fiona had to cut back on both paid and domestic work, and adjust to life as a ‘slowed down person.’ Her husband and children have coped ‘brilliantly.’

Fiona advises other women with early menopause following breast cancer to not ‘push yourself too hard but also don’t give up,’ and to talk to their mothers and grandmothers about their experiences of menopause.