'I went through menopause at 33.'

by AISHA TIMOL

Two years ago I was diagnosed with “Premature Ovarian Failure”, which put me through early menopause.  I was 33 and always wanted to have a family – at some point.

I would love to be writing this story as some sort of freak case but the fact is one in a hundred women will go through menopause before the age of 40.

This little-known fact is heart-breaking for anyone who waits until their 30s to start having children and ends up being part of that one per cent.

I grew up in the 1980s and 90s – a time when girls were actively encouraged to delay starting families in their early 20s, turning away from what their mothers and grandmothers had done, to pursue education, a career and travel.

I was part of a generation where girls were told could be anything they wanted to be – and I still believe this part of the Government’s message and campaign remains true. I recall seeing posters in my classroom featuring girls working in traditionally male roles and teachers telling me that as a straight ‘A’ student I had so much potential and that the world was my oyster.

My generation were told we could have it all.  And we – my friends and I – all firmly believed it.  We all thought that having a family could wait til our 30s or 40s even. I remember secretly harbouring fears in my early 20s that a pregnancy would be viewed as a failing somehow.  Dutifully, I went on to university to get my degree, launched my career, travelled the world, invested in property and followed a path that was both expected of me and that I’d grown to want. Menopause was never on my radar.

But the fact is, as I later discovered, I was playing a game of Russian roulette.  Every year that passed my fertility was declining at a rate of knots – much faster than my peers, most of whom will hopefully go through menopause at the average age of 51.

At 29 I unexpectedly fell pregnant with my first child and now I look at my daughter and realise what a miracle she is.  Just a few years later I was going through menopause, though I had no idea that’s what it was at the time.  I’d skipped only one period – which I put down to stress.  I felt very hot – but I thought it was a really hot spring (it was October) not hot flushes, even though the heat in my body did come over me in waves or surges.

I vividly remember the exact moment I was given the news of my menopause diagnosis – it sounds clichéd but I really do remember it as clearly as if it were yesterday.  It still brings tears to my eyes two years on because the pain of this diagnosis does not go away – in my case this is as much because of the appalling delivery of the news as the fact of it.

I used to work with Dr Fiona Wood, the Director of the Royal Perth Hospital Burns Unit, during the time of the 2002 Bali bombings.  I was the PR Manager of Royal Perth Hospital at the time.  I always remember that Fiona was determined to treat each of those patients as if they were her only patient and emphatically stating her conviction that each and every patient would receive the highest standard of care.

So I left my time working in health thinking very highly of doctors, thinking they all viewed patients as humans and not as numbers. How naive I was.  When I initially went to my now-ex-GP with complaints that I was suffering from hot flushes and night sweats and that a friend had suggested I might be peri-menopausal, he laughed at me.  Not just a chuckle.  It was a sneering laugh as he informed me: “You’re too young for menopause.”

I asked him to humour me and pleaded with him to send me for blood tests to check my hormone levels.  Shaking his head, he agreed. Several weeks later I went back for my results and, looking slightly embarrassed, all he said was: “Turns out you were right – you’ve gone through menopause!”  Just like that.

At that moment, time seemed to stop. My world definitely stopped.  I went into shock – it was as if I was glued to my chair, unable to believe his words.  I kept thinking, no, no there must be a mistake – maybe my results were mixed up with those of another patient?  Through my tears I managed to blurt out:  ‘But I want more children – I only have one, are you telling me I can’t have any more?’

Once more he laughed and said: ‘Oh, that’s out of the question – menopause means that you’re done and dusted.  I’m not sure if you’re a betting kind of girl and you understand odds, but if you are your chances of falling pregnant are about one in a million.”

I continued crying and he sat there silently, offering not one word of comfort. Eventually, he said this:  “The only way it might be possible would be to use a donor egg and even then it may not work.  Besides, having more children is the least of your concerns.  This condition predisposes you to some really serious diseases – you’re now at high risk of heart, osteoporosis and we have to send you for an ultrasound immediately to rule out other things too.”

The man who believed a woman in her 30s was not able to go through menopause was suddenly a subject-matter-expert on it.  It still beggars belief when I think of it.  And with that he wrote me a referral for an ultra-sound and added that I’d probably want to get it done soon.

I was not offered a referral to see a counsellor to deal with the psychological fall-out from such a diagnosis and I strongly believe that this should be offered to any women given this diagnosis as a matter of course.  My emotional turmoil went beyond my physical ability to have more children; it severely affected my sense of being a woman.  As a society, the notion of fertility and sexuality is strongly entwined.   I suddenly felt old and undesirable – despite my other half reassuring me that this wasn’t the case in his eyes.

But I digress.  Trying to make sense of the news and ask the right questions I asked if I should start taking calcium if I was high-risk for osteoporosis.  He said: “You can if you want to.  Whatever good it’ll do you.  These things tend to take their own course.”

I wish I was joking when I recount all this.  It’s incredible really that there are GPs out there – medical ‘professionals’ – who are so ill-informed and blasé, and I hope he is the exception rather than the rule. Today, thankfully, I have found a great GP who has a special interest in the endocrine system, is much more proactive, compassionate and who has a great belief in nutritional medicine.   I understand that these days many universities are actually interviewing people who wish to study medicine to vet them for ‘communication skills’ – aka ‘bedside manner’.  Thank God.

In the past two years I have also joined the International Premature Ovarian Failure Association and through them have made contact with other Australian women living with this condition.

Some were diagnosed as young as 15 years old, others spent their 20s on the pill and when they went to start a family in their 30s found their period never came and the pill had masked all the symptoms of this devastating condition. Speaking to these women is like having found a sisterhood – they understand what I am going through in a way that my friends and family, no matter how much they care, simply cannot.

I also am part of a Facebook support group.  It makes me grateful to live in time where I can make connections with people all over the world who have the same condition as me and exchange information and provide and receive emotional support. I can not imagine what it must have been like for women who had this in the past when such support and information via the Internet was not available.

But the main message I want to get across from my story is that about the relatively new test known as the AMH (anti mullerian hormone) test, which measure ovarian reserve.  Any young women who thinks she might like to have children ‘one day’ would be wise to get that test done.

What this test means is that if you are planning to postpone motherhood, you can now check how many eggs you have left (you won’t be given an exact number per se, but you will get a very accurate idea of what the doctors call your ‘ovarian reserve’.)  Once you know this, you can then decide if waiting til your 30s or 40s is a good idea for you as an individual.  You can request a referral from your GP for this test, which isn’t covered by Medicare but is well worth the $60 it will set you back.  If this was available to me in my 20s and I knew then what I know now, I would have jumped at it.

It may not have change the outcome of having Premature Ovarian Failure today, but I might well have been able to have complete my family and to have gone on to have the two or three children I had hoped for.  That said, I am very grateful to have had one child – there are so many women with this condition who have not been so lucky.