The Unexpected Loneliness of Premature Menopause
I woke up feverish, drenched in sweat, thrashing at my blankets. My thin summer-weight pajamas clung to my damp skin, and my bald head—often cold even in the peak of summer—felt aflame with a warmth that seemed to radiate from within my body. This, I thought, must be a hot flash.
About a month earlier I’d started chemotherapy to treat breast cancer—not a diagnosis I was expecting as a 37-year-mom still breastfeeding my son. Even with a family tree pockmarked with cancer deaths, I figured if the disease was my destiny, it probably wouldn’t strike until I was at least near retirement age.
During chemo class (yes, that’s a thing) prior to my first treatment, I learned all the things I’d lose: white blood cells, some cognitive function, my hair. The instructor turned to me, easily the youngest woman in the room by more than a decade, and added one final loss to the tally: my fertility.
It took me a while to realize that meant I’d be entering menopause in my 30s, putting me among the 1% of women in the U.S. who enter premature menopause (which occurs before 40), according to the U.S. Department of Health and Human Services’ Office on Women’s Health. (Early menopause, categorized as occurring between ages 40 and 45, affects 5% of women in the U.S.)
“Chemotherapy is not friendly to the ovaries,” says Marisa C. Weiss, M.D., breast oncologist and chief medical officer and founder of breastcancer.org. The biweekly cocktail of drugs—known as AC, or “red devil” for its crimson hue and propensity for destruction—used to treat breast cancers like mine is more likely to shut down ovarian function in women over 35, says Weiss. “Women who are exposed to chemo who are under 30 are the ones most likely to regain ovarian function after chemo is over, but in those over 35, the possibility that the ovaries are going to bounce back and get back to work is lower.”
I was already facing so many extreme physical changes—including the bilateral mastectomy I would undergo after completing chemo—and throwing this unexpected side effect of menopause on top of everything else felt like a slap in the face. Now on top of chemo side effects like nausea, crippling fatigue, and taste buds so out of whack that even water was gross, I would also have to deal with the hot flashes, night sweats, weight gain, and reduced libido connected with menopause. While I felt pretty sure I didn’t want any more children, the finality of my childbearing years' ending still stung.
“The cultural stigma around menopause is strong. The normal physiological change in a woman’s life is either silenced by the public, or the symptoms are turned into embarrassing punch lines.”
Since I was battling cancer at the same time, there was no relief for the ravaging effects of menopause. “There’s no one magic pill that handles everything,” Weiss says, “except maybe estrogen.” Because my cancer was estrogen-receptor-positive, hormonal therapies typically used to treat the unpleasant symptoms of menopause were off the table. In fact, as part of my post-chemo treatment plan, I signed up for a decade of taking a drug that would block my cells from using estrogen, a move to prevent more tumors.
The hot flashes and plummeting libido were certainly unwelcome, but at least they weren’t curveballs—as soon as I heard the word menopause, I knew they would come for me. What I didn’t expect was the loneliness of premature menopause. While many of my friends were having babies and enjoying their still-youthful bodies, I was learning to manage mood swings, packing on extra pounds, and worrying about my bone density. At a friend’s house for a visit, I ended up spending most of the evening with her mom, commiserating about our shared insomnia and the fact that menopause sucks. I felt like an old woman, an outsider among my own peers, who couldn’t possibly understand what I was going through.
What was even more isolating was that, while there were plenty of resources for navigating a breast cancer diagnosis, I found very little out there to help me through post-cancer menopause. Not even the perky pink breast cancer awareness movement had much to say about this less-than-inspiring leg of the journey. “The cultural stigma around menopause is strong,” says Jennifer Merschdorf, CEO of Young Survival Coalition, an organization that offers support and resources to women under 40 diagnosed with breast cancer. “The normal physiological change in a woman’s life is either silenced by the public, or the symptoms are turned into embarrassing punch lines. Add to this paradigm being a young woman who isn’t supposed to experience this normal change for 20 or 30 years—the shame, isolation, and bewilderment a young adult with breast cancer can experience is intensified by the timing being much earlier in the life span.”
Ultimately, my greatest allies in my quest to understand my ever-evolving body were my doctors. (Resources like the Young Survival Coalition and breastcancer.org also have great information.) Working with my oncologist and ob-gyn, I figured out ways to manage my symptoms—from upping my calcium and vitamin D intake to finding an anxiety medication that helped stabilize my moods—and start to feel a little more like myself again.
Though my hot flashes have mostly abated and my mood is far sunnier, I still deal with ongoing symptoms of menopause. But I’ve learned to take these changes in stride, grateful to still be here, rapidly wrinkling skin and all—and more important, to talk about them. For me, menopause was lonely, but it doesn't have to be.
Jennifer Bringle is a writer in Greensboro, North Carolina, working on a memoir about her post-cancer experience. Follow her @jcbringle.
Originally Appeared on Glamour
