The women we interviewed described the impact of early menopause (EM) on a range of personal relationships – with partners, children, parents, other family members, and friends. As Jacqueline, who experienced medically-induced EM as a result of endometriosis treatment said, ‘You think, ‘Oh, it’s just happening to me.’ But it’s also happening to the family unit, or the extended family and friends.’
Intimate relationships
About two thirds of the women we spoke with were in intimate relationships, or had been previously. They described EM as affecting their partnerships in several ways, including through symptoms (e.g. ‘mood swings’, hot flushes, night sweats), loss of fertility (see Emotional impact of early menopause and fertility loss), and loss of interest in and enjoyment of intimacy (see Intimacy, sex and dating after early menopause). Women who had experienced cancer described the dual impact of both cancer and EM on their relationships.
Kirsty shared the kinds of pressures that spontaneous EM and learning she carried the BRCA2 gene mutation had placed on her relationship with her husband, and how they had responded.
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When we lost our pregnancy, we both went through really heavy grief because we had known so early at three weeks that we were pregnant. By the time we reached 12 weeks, you know, we’d had a lot of time to start planning it in our minds. So for both of us that was a really challenging time. When I got my early menopause diagnosis, my husband didn’t show a lot of signs of grief. He just made the decision to be strong for me and I’ll always be really grateful for that.
He, all of a sudden, it was all about me you know, “How can we get you through this? What do you need? Do you need to go and see a psychologist? How can we alleviate these symptoms? How can we make you okay in this moment?” And also being mindful about BRCA 2, he was very strong on not doing IVF if that meant any sort of risk to breast cancer. He’s like, “Well, I can have a baby, but having a wife who’s not here doesn’t help the situation.” So he’s been really supportive.
Recently we had a talk and he told me actually how hard that time was for him, but at the time he didn’t show it. I was really lucky to have a partner where fertility wasn’t a deal breaker. That at the end of the day, he said, “if you know, If I chose a baby or I chose you, I’d choose you every time”. And I’ve been really lucky for that because if I’d been married to someone who was even more set on having a family, maybe they would have been pushing me to do adoption or do surrogacy or have egg donation and carry it myself and be okay with all those risks. Because, you know, often people’s drive to have a family is very strong.
My husband had a really strong drive to have a family, but at the end of the day, he valued our relationship more and I was really lucky to have someone who’d do that because I can think of people in my life, men in my life, who if I was married to them and this had happened, maybe that would have been a different story.
But we made a decision very early on in our relationship that we would always be a team, and in this situation, we continued to be a team and that has been absolutely key to our relationship getting through a really challenging time. And he’s even someone who doesn’t like sleeping under a fan and he now sleeps under a fan for me in summer because he knows that it helps my hot flushes, so you know, he’s made a lot of allowances for me. And also, it can’t be easy living with a woman, going through menopause who doesn’t sleep that much. I’m sure I’ve had my crazy moments and he’s been very understanding of that. So I’m incredibly lucky to have a partner who will stand by me through whatever gets thrown our way.
Many women described feeling well-supported by their partners. Ways in which partners helped women included attending appointments with them, helping them make decisions about their health, taking responsibility for housework and childcare when women were unwell, affirming the importance of the relationship over having children (for couples who did not have children), adjusting to different sleeping arrangements, helping them with ‘anxieties’ about physical changes such as weight gain or surgeries, providing financial support, and not ‘pressuring’ them for sex.
Fiona described her husband’s support while she was going through breast cancer treatment and surgical menopause.
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My husband, he was raised by his mum and older sister, so he had always been a very responsible person. So when I wasn’t well he took over and we’d both lived apart and been you know lived on our own and had our own houses, all of that sort of stuff before we met. And so he was perfectly capable of running a house and so was I. So when I was unavailable, he was quite good at running the house. He was quite efficient at maintaining, you know updates via SMS to people, which was you know pre-Facebook sort of stuff. And he was quite good at running the kids and keeping them away from me so they didn’t tire me out too much when I needed it. And then helping me when I wanted to be around them and stuff like that. So he was brilliant through all of that.
Every single treatment it was always, it was never about money, it was never about what he thought, it was what I chose. So in that, I knew he was standing behind me 100% and I know not everybody can say that, but that made a huge difference, because he could actually sit and say, ‘Look, it’s your decision’. He wouldn’t even give me an opinion half the time. I’d say, ‘Well what do you think?’ And he’d go, ‘Look it’s got to be right for you.’ And he’s right, it’s got to be right for you and your own… you live in your own body, you’ve got to make the decision yourself. You can’t let anybody else influence you, it’s got to be what you’re happy with. And yeah, my husband was a really great sounding board because I could talk to him. But he would always bring it back to me and say, ‘It’s your call. Your call, your call’.
Some women expressed concerns about the burden on their partners of caring for them while they were unwell, or of having to adjust to the implications of EM such as changes to their sex lives or not being able to have children. Those in new relationships felt particularly vulnerable and were uncertain if their partners would want to continue the relationship.
For a time
Maddy felt ‘depressed’ and ‘anxious’ in relation to spontaneous EM, which she felt was ‘very difficult’ for her partner.
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So I’m in a same sex relationship so the upside to that is [laughing] she understands so she completely, although she hasn’t been through it. She gets her period every month and she used to have very painful periods and have a bad time every month actually. So she understood and saw me and could see what I was going through and she was determined to get me treatment just as much as I was. So she was super supportive – and still is – came to every appointment with me, asked questions just like I did.
Was she with you when you got the diagnosis?
Yes, she was. Yeah. And she couldn’t believe it either. Like we still talk about it now and just, you know, just go remember that day? Yeah. So she was very, very supportive to me but that was taxing on her because I was talking to her about things and I should have been talking to a counsellor. So yeah, it was very, very difficult for her because she sort of went into this sort of carer role with me and just trying to get… Seriously she’s trying to get me up, get me showered and get me to work and back home and she was doing cooking and cleaning because I didn’t have any energy to do anything.
So she was taking care of me and it sort of changes your relationship when you’ve got someone who’s feeling terrible and also their personality’s changed because I had become quite depressed and anxious at the same time. There’s days she stayed home with me because she didn’t want to leave me by myself, too scared to leave me by myself. So very, very, very difficult on her and I remember that, how hard it was. You know, and even sometimes now it still is as in she encouraged me to go see a counsellor. Although my GP had given me the referral and go see a counsellor and I was putting it off, putting it off, putting it off but she kept asking me and saying “I think it would be good, maybe you should do that.” So yeah, I couldn’t ask for a more supportive person.
Vicki, who had Turner Syndrome, described sometimes feeling as though her partner would not ‘want’ her because of her health issues and potentially not being able to have children.
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As for my partner, we’ve had really open conversations from the get-go. Even before I was going out with him, he knew elements of what I was dealing with. Like he didn’t know everything, he knew that I had other health issues, not necessarily in detail, but he knew that I had other health issues.
And then there’s been times where I’ve been in tears and gone, “You don’t really want me!” He’s like, “Yes I do!” [laughing] But I’ve gone, “What, even with Turner’s, even though you’re not going to get a kid out of me?” And he’s like, “Yep, not going to, yeah, not going to turn me away,” kind of thing. So you know, I’ve given the option, but yeah, and then he’s like, “Well, it doesn’t matter.” So yeah, I’ve had a lot of good support there.
Several women expressed appreciation for the support available to their partners, through friends, family members or even employers. At the time of her risk-reducing oophorectomy, Lydia said, ‘[my husband’s] workplace were fantastic. They were just like, “Yep, if you need to take time off, or just work half days for a little while that’s fine.”’ Others described partners as having little support for themselves. Eden’s partner decided not to attend a support group for men whose partners had breast cancer, because, she explained, ‘he just thought, ‘It will all be men 20 years older [than him].’
Julia was ‘eternally grateful’ to two of her partner’s friends for the support they provided to him during her experience of Hodgkin’s Lymphoma and medically-induced early menopause.
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He’s got a wide circle of friends but there was two friends in particular. One lived away but called him very, very often and still does. And the other one threw him into his mountain bike activities and they built a mountain bike track and course together as part of… I think, this friend’s version of therapy was to get him out in the bush with the machetes and the boys bits and pieces and a few beers, and that sort of thing, and built a mountain bike track. And then they could talk, they could chat he could escape from his own thoughts. So those two particular friendships were, you know, I’m eternally grateful to them for being there in that way.
A couple of women described their partners as not emotionally supportive. Mary described EM as contributing to the breakdown of her previous marriage, in part because her former partner was ‘dismissive’ and ‘not understanding.’ Nancy’s husband supported her financially and practically through cancer and EM, but was ‘no good to talk’ with. Instead, her friends provided her with emotional support.
Relationships with children, parents and other family members
Children
Women who had children discussed the impact of EM on their relationship with their children. A few spoke about concerns about EM, cancer, or other conditions such as ovarian cysts being hereditary and the challenge of discussing this with their children, particularly daughters (see Emotional impact of early menopause and fertility loss).
Others commented that EM symptoms had affected their parenting, making them more irritable, anxious, or short-tempered, or shared how they had explained EM and its implications to their children.
Mary described the impact of EM on her relationship with her children.
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I’ve told them. But they’ve always known I went through menopause early, much earlier than most women. They’ve had to deal with some of the mood swings, that’s for sure; me screaming at them. Horrible. And them not understanding why I’m so – why mummy’s so angry. Yeah. And occasionally I’ll say, “Look, I’m sorry, I didn’t mean to yell at you, but, you know,” I would try and explain.
My daughter was only three so it was kind of hard to explain to a three year – and my son was only six. But I didn’t really tell them a lot then obviously. [laughing] But in the sort of subsequent years I’ve said, “Look, this is what happened to me.” And they know the full story. Yeah. But they’re understanding I suppose.
The one good thing is I always wondered whether, like, before I started going through menopause at 37, when I had a daughter I thought, ‘Oh my God, she’s going to hit puberty when I’m going through menopause.’ [laughing] So it’s good that we’re not going through the changes of life at the same time [laughing] because I was, like, ‘Oh my God, that’ll be horrendous,’ you know, [laughing] in the household. So I’m glad I’m through mine while she’s going through hers now. [laughing] Yeah.
Jacqueline described the kinds of conversations she’d had with her child about medically-induced EM.
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Because it is a huge… it is a lifestyle change. It’s as dramatic for me going through menopause as it is for a teenager, because I went from hormones to no hormones [laughing], you know. And my body went, ‘Hang on, we usually operate on a different set of hormones and now you’ve taken them all out.’ So, yeah, sometimes I call it – when I’m trying to describe it to my child – as I was going through ‘un-teenagerhood’, you know.
It’s that kind of similar thing where my hormones have gone from something to nothing and, you know, trying to find something to explain to, you know, my child, is really hard. Because how do you couch it in, “This is what mummy’s just been through,” you know. “And that’s why, you know, mum’s, you know, feeling a bit cranky today or she’s not sleeping or, you know, she’s having a bit of a cry,” you know.
I’ve found it really hard, you know, the whole discussions about, you know, when you have your child go, “Can I have a brother or sister?” And you go, “Well, actually, no.” [laughing] That’s a hard conversation. I say, “I can’t. So do you remember when mummy was in hospital? So unfortunately we can’t. So love to but, you’ve got your cousins. [laughing] And you know how you get jealous about those cousins [laughing] so imagine that!” So a bit of logic, kid logic there sort of wins the day. Yeah.
Parents
Women’s relationships with their parents were also shaped by their experience of EM. A few women felt they had ‘disappointed’ their parents by being unable to ‘give them’ grandchildren, and appreciated it when their parents made it clear this did not matter (see Emotional impact of early menopause and fertility loss). Others reflected that not having children themselves freed them up to care for elderly or ill parents.
Natalie described having more time to care for her parents as the ‘silver lining’ of not being able to have her own children as a result of EM.
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So every now and then the emotional side of it still gives me a bit of a kick but I’m definitely a silver lining kind of person. I try to look at the fact that, you know, the fact that my husband and I didn’t have kids. My dad got very sick with cancer not long after that, so we weren’t tied up with children, so we were able to help look after my dad with my mum. When my mum’s Alzheimer’s got really bad, I didn’t have to run around picking kids up from school. I was able to look after my mum. So there’s been silver linings in it kind of thing as well.
Several women described asking or wanting to talk with their mothers about their experiences of menopause. Some women’s mothers were happy to discuss these matters. Jenni said that because her mother went through natural menopause while Jenni was experiencing EM, she was ‘compassionate’ about menopausal symptoms. Others were less ‘forthcoming,’ as Anna described her mother, or seemed to lack empathy.
Yen-Yi was close to her mother but recalled feeling ‘resentful’ over the fact that she didn’t seem to ‘understand’ her experience of menopausal symptoms as a result of ovarian suppression therapy.
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I found that I was really short-tempered with mum … Or, you know, I just feel that she doesn’t cut me any slack and because I think we’re always pushing each other’s buttons, so there’s a lot of screaming and shouting, a lot more than normal. I mean we’re very short-tempered, very short-fused, but it blows over quite quickly. But some of this just was very prolonged. And for a while I felt really resentful and then I just felt like there was this barrier and I just couldn’t reach her and I just couldn’t get her to understand what was going through my head. I just felt like, ‘You’ve gone through menopause, you haven’t gone through cancer, but you’ve gone through menopause, I thought you would understand me better’ And yeah, so and then my sister had to be the go-between a lot of times.
A couple of women reflected on experiencing EM after their mother had passed away. Jacqueline said her elder sister was her ‘source of information about menopause’ as their mother had died many years earlier.
Joanna, who experienced medically-induced EM after treatment for Hodgkin’s Lymphoma, shared what it was like not having her mother around to ‘bounce stuff off’.
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From a family perspective, if you were going to talk to anyone you’d talk to your mum about it and I think not having that sort of reinforced to me the not having mum to bounce this stuff off. And I think this stuff that… and I just found this in general after you lose your mum, there’s stuff that really no one else is interested in but you know your mum’s going to be interested, whatever random stuff happens during a day. So I think it’s sort of tied up with that as well.
In relation to the early menopause side of things, definitely, I’d look to the women in my family to help with that. Yeah, even though my dad’s a retired pharmacist, you know, there’s some stuff that you don’t really talk. And I don’t feel like again, I think it was all caught up in a lot of other issues but I felt like they didn’t acknowledge or mainly my dad and my brother didn’t acknowledge how big an impact it would have on me to know that I couldn’t have children. I just sort of thought ‘You should get this,’ you know, but in terms of support, you know, I guess the two family members who were closest to my mum would be the two, my aunt and my mum’s cousin would be the two who, you know, I would be able to speak to and say, “What do you reckon, this, that and the other,” you know. So that’s been important I think.
For many women, parents were an important source of practical, financial, and emotional support during the experience of EM, particularly younger or single women, or those who experienced cancer. Some described moving back in with their parents, or having one or both parents travel from overseas or interstate to care for them.
Sylvia’s mother travelled from interstate to support her during her treatment for uterine cancer and surgical menopause.
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So my mum was really good. She came down. As soon as she found out she came down sort of every sort of six weeks to see how things were. She stayed for, she was there through the operation and post recovery to make sure that I was okay, that I was recovering the way I should. So she was sort of there for a couple of weeks, which was fantastic. She was really supportive around getting the growth out as quickly as possible. She felt that having children was something, you know, that didn’t really matter too much. She felt that it was more important that I was okay.
She felt that it was a spiritual and emotional, as much as it was a physical process. So she really focussed on the emotional and spiritual elements of the impact of having something like this. So she really worked hard to encourage me to go to all the appointments and she booked, you know, counselling and things like that to make sure that I had the emotional support. Because she knew that I probably would have gone, “Nah, I don’t have time for that. [laughing] Who has time for that?” So I just, yeah, so she was really good from a practical perspective. And she kind of came down when she could, as often as she could.
Having to become dependent again on parents was bittersweet for some women. Alex said, ‘I’m now closer to my mum and dad but not in a nice way, you know – in a way that I’m so dependent upon them and they have to look after their sick daughter who’s meant to be out enjoying life at this age. So that’s kind of a sad closeness that’s come about from [ovarian cancer and EM].’ Not all women felt emotionally closer to their parents as a result of EM and/or cancer. Kate said her parents were ‘more the “I’ll make you some lasagne and put it in the freezer” type people, which I appreciate, but I’m a bit of a talker now.’
EM also impacted on relationships with other family members, including siblings, aunts or grandparents. A few women had other family members who had also experienced cancer or EM, while a couple mentioned discussing egg donation with their sisters.
Lydia, who experienced EM following a risk-reducing bilateral oophorectomy, described the support she had from her sisters who also carried the BRCA gene mutation or who had experienced cancer.
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One of my sisters in particular, the one that was diagnosed second, she just lives around the corner from me so she was one of my biggest supports too, we’re quite close as well. She was over and I could call her at any time to say “Hey, what about this?” She was good with regards to talking about symptoms and “Hey what do you think about this, what about that?” And she’d go, “Oh no I didn’t,” you know, “I didn’t have that,” or “Yes I did and this is how I dealt with it,” and yeah.
So, she was actually the one that pointed out about like if you’re upset about something how it can bring on the hot flush. So she said, just be aware of that and, yeah, so that was good her pointing that out. And, you know, she had said, there was one day, it was really hot and I said to her, “I’ve had so many hot flushes today, it’s just driving me crazy,” and she’s going “It’s like 35° what do you think” and I’m like “Yeah, and…” She’s like “It’s hot, you’re hotter, you have the hot flushes,” I’m like, “Yes okay.”
Friendships
Many women described EM as challenging in terms of their friendships with other women. After EM they felt they had ‘less in common’ with certain friends or that friends could not ‘relate’ to their experiences, or found it difficult to maintain certain friendships due to fatigue, different interests, or different lifestyles (particularly if women with EM did not have children) (see also Early menopause and identity, social connection and future plans).
Sonia described the impact of being diagnosed with spontaneous EM on her friendships.
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[My friends] were as supportive as I think they could be. But what’s interesting is, you know, many of them were like mothers of very small children, and they were dealing with, you know, sleep deprivation and crying babies and up all night, and you know, maybe their second or their third child, and partners that were working long hours, and you know, all of the stuff that goes along with very young families. And here was I in menopause. So not only dealing with that grief, but also trying to cope with the physical transition. And, you know, I don’t think anyone sort of really got it. Not that I blame anyone at all for that. But it was extraordinarily isolating, really isolating.
Did you change the way you socialised with them at all for a while ?
Probably for a while. I would say maybe for the first year post-diagnosis, because I think in a way I was in quite a lot of shock. I probably socialised less, yeah. And I probably disengaged a bit from everyone’s children – not completely, I mean, I still saw everyone’s kids. But I definitely pulled back from socialising, because I just wasn’t always up to either being around everyone’s kids and celebrating, you know, birthdays and milestones and whatnot. And sometimes I just wasn’t up to it because I was really in a lot of grief, yeah. … I mean, I certainly didn’t pull out altogether, but there was a change. And there was just a lot of grief to work through. So anyway I just felt sort of quiet and, you know, like I needed quite a bit of space, yeah.
A few women, however, commented that some friendships became closer, or that through EM they had made new friendships.
Julia reflected on the way her old and new friendships had evolved during the course of cancer, EM, and her friends’ life experiences.
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In terms of my close girlfriends, one already had a couple of kids, one of which actually got diagnosed with leukaemia while I was sick, so, another blood cancer, so that’s brought us closer together in things. But a couple of my closest girlfriends haven’t had children and actually haven’t had partners up until the last couple of years, yeah.
One that had one that I’m very, very close with, girlfriend had cervical cancer when I was sick and has had challenges and difficulties. And I always imagined that she’d be the one with a child and me not. So I’ve been quite… While she’s come to terms with things and has accepted that children won’t be a part of her life, I’ve found it quite difficult to try and balance my excitement with talking too much about things.
I’ve certainly had phone calls where I’ve mentioned nothing whatsoever at all and focused on everything that she’s got going on and I’m very sensitive to it and I have another couple of girlfriends who have now met partners. They have some instant families they didn’t expect, but would also like to have their own children and now that we’re heading towards the 40 age it’s me hoping that their ovaries are going to do the right things for them.
So I’ve probably been quite lucky in a sense, that I’ve had some of those girlfriends that are without children, that’s probably helped, helped me. And also helped in terms of having those friends who can pick up and go out for a coffee straightaway, or go away for a weekend, or haven’t had those commitments and things around. That’s really been, yeah, helpful really when I think about it. I hadn’t perhaps thought about it in that way but reflecting on it I can see that’s definitely been helpful.
So everyone’s life diverges in different ways, it can be quite similar until your mid to late 20s, if you’re on that sort of university, overseas travelling, first jobs meeting people, meeting partners, that kind of track. And then it just goes off in multiple tangents, and I think that’s when there can be challenges. Whether you’re in this situation or people who were long term single or haven’t necessarily found the right job for them, just so many parameters that are changeable, that can change the balance of friendships.
And people aren’t going to understand you. You wish that people could understand, but no one’s walked in your shoes. Although, you know, having friendships like the one that I have with the friend that I have made through cancer has been invaluable. Having someone to talk through all of those things, I didn’t think she’d be here to talk to. [Tearfully] And she recently got engaged and asked me, you know, what the likelihood would be that we would come overseas for her wedding. Because of her background I spoke about, she wants to get married overseas in her sort of homeland as such. And then I was able to say, “Well, it depends how easy it would be to travel with a six month old.” And that’s how I announced the pregnancy news to her and she lost it and I lost it and you know, it can be just amazing.
I mean, I wouldn’t have a friend like her if it hadn’t been for this experience and of course, you’d like to say you’d take cancer back… I definitely want to take cancer back, but I wouldn’t want to take back what I’ve learnt or the relationships that have grown and flourished from it. It’s an amazing life experience, the biggest life experience obviously that I’ve ever had and the person that I’ve grown to become because of it is a person who’s a better person, I think, for it. As my girlfriend who had cervical cancer said, “If everyone could have the lessons without the cancer, it would be a better world.”
Further information:
Talking Points (Women)
Talking Points (Health Practitioners)
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