Long-term health effects of early menopause

I know that I’ve got a greater risk of cardiovascular disease and bone density problems, those are the two main ones that I know. If there’s others maybe I don’t know about them, yeah, and so I feel like the cardiovascular stuff I don’t have a family history of that. And I through lifestyle things, try and manage that the best I can, and the bone density I’m taking my calcium and Vitamin D and trying to have weight bearing exercise and eating well. I think that’s all I can do there and they’ve said just do what you normally do, don’t change your life at this stage.

So it’s interesting because I really haven’t been told hardly anything and I’m the person that’s had to bring it up with the GP when I have. So I’m the one that’s asked for the, or raised concerns about bone density. So I had the DXA scan; is that what it’s called? – and come back osteopenic. So I feel like, on the part of the medical professionals or the GP, they’ve not been proactive, you know, in saying, “Okay, this person had a hysterectomy, an oophorectomy at, you know, early age. Here are some of the things that we need to be conscious of, and, you know, maybe some of the conversations that we need to have with the patient.” It’s been me that’s sort of saying, “Hey, you know, because of this” – and I don’t know what the long term risks are. So it’s only the ones that I’m aware of that I’m actually bringing up with the GP whereas I’m sure there’s others that I’m not aware of that the GP equally is not raising with me either.

So because you’ve mentioned you don’t eat calcium – sorry, you don’t eat dairy – so do you do anything else to kind of…?

Yeah. So when I suggested a number of years ago that I should take calcium tablets they said, “No, don’t worry about it.” And since having the DXA scan they’ve now said, “Yes, you need to take CAL-DK [calcium, Vitamin D3, Vitamin K],” or whatever it’s called. I’ve also spoken with a physiotherapist about, you know, muscle tone and that sort of stuff that can potentially help both in terms of balance and also in terms of, not losing anymore bone density, all that sort of thing.

But – and I guess it’s an unconscious incompetence; you don’t know what you don’t know … And I always feel like I’m kind of scrambling for information, to then be able to kind of make some decision as opposed to somebody saying, “Hey, you know, you’ve had early menopause. Here are some things that you need to think about or consider.” It would be nice if somebody did that.

Another thing I did, and I took advantage of being in the health field, working in the health field, and I saw that there was something at the [women’s health clinic] on early menopause. So I went as part of my job, and well I went because I could say it was part of my job, but really I was there on a personal level. And so it was very technical and I did learn, and I was a bit shocked by some things I learnt that night. And again, there wasn’t really – I know there wasn’t any support for people. So that was another thing I did.

She did then move quite quickly into making me aware of the health risks with early menopause and obviously that’s for all women, but particularly in that, in that phase where you’re not getting the oestrogen to your bones and that, as you otherwise would. So she was really very upfront about the cold hard facts and I remember her saying you will be breaking bones at a drop of a hat in your 60s or earlier, if you don’t do something. And she talked about the enormous benefits for bone health and I did have a bone density scan and I have already got the early stages of osteopenia which – comes before osteoporosis. So that was again an indication of my bones are already being affected. So once again that was more evidence for her that we really needed to act, act quickly and I think if I put my foot down and said I do not believe in taking it she would have accepted that, but not without telling me all those risks.

I think for me it was then weighing those up. She talked about the risks of heart disease and breast cancer as I recall – and I think I knew that anyway, but being two risk factors associated with taking HRT. But she really said in my case the benefits would far outweigh those risks, said that I would probably be best to take HRT for at least 10 years and then maybe rethink it, review, but she said at least until I’m really up over that 50 years of age. Again, just to support my skeleton really. To also take Vitamin D and also to exercise.

She said you just need to be looking after yourself and it’s not just about taking the HRT you need to do all those other things as well. So I actually do take calcium and Vitamin D supplements and that was recommended for me to do that, but also try and exercise a couple of times a week. So I’m doing weight-bearing exercise and she said that is really just as important. And then I see for me the role HRT has played has allowed me to have the energy to actually undertake exercise because I think I would have really struggled. Well, I certainly would have back at that time, yeah, having the energy to do that.

So, yeah, so she certainly talked to me about, you know, eating well and she did talk holistically about looking after myself, it’s not that HRT will just fix everything, but that it was just so vital for my bone health.

I make sure that I get a breast check every two years, I make sure that I get a DXA scan every two years, but no [health practitioner] sort of has the finger on that pulse, other than me, it’s very self-driven. […] So I get my hormone levels and thyroid levels tested. Most importantly I get the auto-immune antibodies tested for thyroid disorder. I get cholesterol, Vitamin D, iron. I do a mammogram every two years since diagnosis of early menopause, because that, that was recommended to me actually at the time, and so was DXA scans every two years. So I do both of those. I’ve always done pap smears so I still do those. I think that might be it.

Did anyone talk to you about the long-term implications of early menopause?

Yes, and it scared me a lot. Because the problems – the bones problem and some of them made me believe that I could get old faster than the other woman in my age. So they say to me to keep doing the hormonal replacement [therapy] because if I stop maybe my body will be – stop to work and I will have big problems related with this. So, yeah – it’s really scary. [laughing]

Did they tell you about anything else you should do other than hormone replacement?

Just get fit and eating healthy which I [always] did. Another thing that I was always healthy and I always was athlete or – I always took care of my body, like, so [laughing] it’s strange to think, ‘Why? How about all those things? I always took care of it.’

Yeah, and I always was going to the doctors and making check-ups and now suddenly I found out I have a really big problem.

I guess as part of my diagnosis – I got the fear in me. It was a big process, like being told that having premature menopause means that you are at a higher risk of heart disease, you’re at a higher risk of osteoporosis and dementia. That’s a hard thing for a woman in her early 30s to hear. On top of, I have the BRCA 2 gene, and all the other complications in my body. That was hard to hear.

So, I was really careful about where to get my information about early menopause, particularly because I’d started hearing from doctors around some of the high risks of someone so young having a drop of oestrogen in their body, like the osteoporosis, heart disease, dementia, and that compounded with all the other things I have as complications in my body. It was enough to really send me into a spin of mental health issues and health anxiety. You know, wondering whether I’m even going to see 50 as part of it.

And I guess that uncertain future is why I really try and focus on the present because it’s hard to navigate. What I know is that I can monitor it.

As you go by, you just sort of adjust your lifestyle and you realise that you just don’t have the same flexibility you used to. Picking things up off the floor, bending down it’s just little things like that. But it’s one of those things that you just learn to live with eventually.

And now it’s second nature, you know there’s pre-40 and then there’s the post-40. Or there’s the pre menopause and post menopause. So the first young half of my life is over, now the mature wise elderly part of my life is just starting. But you know I’m not that old and I’ve got hopefully enough years left to see my kids grown up and oh maybe one day grandkids, see how they feel. But in the meantime it’s just dealing with the body that I’ve got and waking up and realising I’ve woken up each morning and being happy about it.