‘It's not supposed to be this way’: Psychological aspects of a premature menopause

Abstract

Background: Premature menopause (menopause diagnosed at 40 years or under) is a challenging condition with no prevention or cure. Causes can be the result of surgical intervention or spontaneous and largely unknown. It affects 1–6% of women aged 14–40. Aim: This study investigated women's experience of diagnosis, perception of cause, treatment received, main concerns, perceived long‐term consequences and impact on psychological wellbeing. Method: A cross‐sectional single group design questionnaire study that included both quantitative and qualitative measures was used. It was distributed to women on the database of two specialist London clinics and an internet‐based patient support group. A thematic analysis was undertaken. Findings: The response rate was 62%. Women's experiences varied but showed common themes regardless of timing of diagnosis and services accessed. Improved understanding by health professionals could help this group accept and adjust to the condition more effectively as could psychological support. Fertility was a primary concern regardless of parity and there were several secondary impacts both physiological and psychological. Discussion: A clear need for the offer of emotional support was indicated for all, but particularly for teenage girls and single women who tended not to access support from their own social network. Conclusion: Young women with this diagnosis could benefit from the offer of counselling, though uptake may be influenced by individual factors and vary according to age and circumstances. A good understanding of the physical aspects of this condition is important in the counselling of this group.

‘My relationships have changed because I’ve changed’: biographical disruption, personal relationships and the formation of an early menopausal subjectivity

“…Reflecting the close perceived links between femininity and fertility, youthfulness and sexuality, EM/POI can also have complex impacts on gender identity (Parton et al . 2017, Singer 2012). Sex and intimacy for many women are inextricable from feeling physically attractive, and concerns about lacking ‘reproductive potential’ (Parton et al .…”

“…2010, Parton et al . 2017, Singer 2012). Intimate relationships in turn influence women’s experiences of and adjustment to EM/POI, though little is known about how (Abadi et al .…”

“…Family relationships have been examined even more sparingly, with indications that support from mothers and sisters can assist women’s adjustment to EM/POI (Knobf 2008, Singer 2012). Some women describe greater affinity with older female relatives in sharing experiences of menopause, however, for others this exacerbates feelings of being ‘out of synchrony’ with peers (Parton et al .…”

“…Early menopause (EM) or premature ovarian insufficiency (POI) can introduce profound transformations to a woman’s health, emotional wellbeing and sense of self (Boughton 2002, Orshan et al . 2001, Singer 2012). While the usual age of menopause is between 45 and 55 years, menopause before age 45 is considered early, and POI refers to the loss of ovarian activity before age 40.…”

Women's Experiences of Diagnosis and Treatment of Early Menopause and Premature Ovarian Insufficiency: A Qualitative Study

“…1 It can also impact on women's sense of self and personal relationships. [2][3][4] Despite knowledge gaps in relation to causes, physiological effects, and treatments (including their long-term impacts), the clinical literature on EM/POI is significantly more extensive than qualitative research examining women's lived experiences of the condition. 1,5,6 Within the latter scholarship, work on iatrogenic EM/POI predominates, likely reflecting its greater prevalence and intersections with qualitative research on experiences of cancer.…”