EMW09 (Maree)

Name: Maree
Age at interview: 40
Diagnosis: Medically-induced Premature Ovarian Insufficiency (POI) (following breast cancer treatment and a risk-reducing bilateral oophorectomy)
Age at diagnosis: 39

Background: Maree lives in a metropolitan city with her partner and their two children. She is not currently in paid employment, and is from an Australian background.

About Maree: At age 39, Maree was diagnosed with inflammatory breast cancer and underwent chemotherapy, a bilateral mastectomy, radiotherapy, and an oophorectomy, which caused premature menopause. As her cancer was hormone sensitive, she also takes anastrozole to suppress oestrogen production. Maree’s menopausal symptoms include hot flushes, irritability, mood swings and dry skin. Gabapentin has helped alleviate her hot flushes. Maree remains concerned that her cancer may come back, but is now focused on ‘the day-to-day and the near future.’

More about Maree: Maree was diagnosed with inflammatory breast cancer at 39, after noticing a hardened red rash on her left breast. She underwent chemotherapy, followed by a bilateral mastectomy and radiotherapy. As her mother had died of ovarian cancer, Maree decided to get tested for the BRCA 1 gene mutation. A positive result prompted her to have her ovaries removed.

Maree’s periods first stopped during chemotherapy, which she saw as ‘a positive thing’ because she already had two children, with no plans for any more. Following her oophorectomy, she was diagnosed with premature menopause and referred to a menopause clinic where she received information on menopausal symptoms and how to alleviate them. As her cancer was hormone sensitive, Maree cannot take Hormone Replacement Therapy (HRT), so deals with her menopausal symptoms through diet and exercise. She is currently taking anastrozole, which further lowers the production of oestrogen in postmenopausal women who have had breast cancer, and she has found that it accentuates her menopause symptoms.

Maree experienced ‘intense’ hot flushes, which have disrupted her sleep, and mood swings, irritability and dry skin. She takes gabapentin for nerve pain and has found that it helps alleviate her hot flushes and she can now sleep through the night. Maree also uses a non-irritating moisturiser to help with skin dryness. She has noticed that she sometimes experiences issues ‘keeping a train of thought’; she now keeps a desk diary and writes everything down. Maree described being concerned about her long-term health, particularly bone density, and takes a vitamin D supplement.

As she cannot do high impact exercise due to the after-effects of cancer treatment, Maree goes on daily long walks with her partner and does physio exercises at home. Maree described her partner as ‘very supportive’ and said she can talk to him openly about her symptoms. While she ‘couldn’t imagine’ undergoing cancer treatment without her the support of her family and friends, Maree said she tends to discuss her menopausal symptoms ‘in a humorous way’ with people who have not experienced it yet. She does not feel that they can ‘personally understand the emotional impact,’ and so she is more comfortable talking about her symptoms with women who have experienced menopause.

Maree feels that premature menopause after cancer is ‘not easy but it’s manageable.’ She encouraged women with similar experiences to ‘focus on each step of the way,’ put their health first, and keep lines of communication open with their partners.