The Impact of Premature Menopause on Fertility | Stella
Her story
14 mins

How premature ovarian insufficiency and early menopause affect fertility

byEmily Turner

Victoria Walkden thought she’d be a mum to a large family but premature menopause took her on a complex path to motherhood. She shares the lows and highs of her IVF experience and her difficult return to work. She also explains why more needs to be done to raise awareness that you can be young and menopausal.

I’ve always been maternal and wanted a huge family, yet I had a sixth sense that something would go wrong. I started trying for a baby when I was 25 and went to the GP after 12 months of not getting pregnant. The doctor told me to give it time as I was only young.

I left it for another six months and they tested my anti-Müllerian hormone (AMH) levels, which revealed my egg reserve was super low. I was shocked as my periods had always been regular.

This was the start of my extreme anxiety and desperation to become a mum. I struggled with the realisation that it may never become a reality. The sixth sense I had felt all those years ago had come to fruition. I felt I had brought this on myself and manifested that I wasn’t going to have a baby.

I became pregnant a year later but it was an ectopic pregnancy and, to make matters worse, it went undiagnosed as a miscarriage. It became a life-threatening emergency after my fallopian tubes ruptured and I haemorrhaged due to the time I was left bleeding with the “miscarriage”.

I had an emergency operation and they removed my right fallopian tube, leaving me in absolute turmoil about my fertility. Not only was I dealing with low ovarian reserve, I only had one fallopian tube left.

I didn’t understand what was going on with my body and I wasn’t getting constructive information from the medical professionals treating me. I felt alone and in an abyss. At this point, no one told me I had premature ovarian insufficiency (POI) and was going through premature menopause as a result. I tried to stay positive and held onto a belief that everything was going to be ok.

Read our guide to premature and early menopause.

The realities of IVF when your egg reserve is low

I began my IVF journey and was told I had a 2% chance of conceiving. My remaining fallopian tube wasn’t producing any follicles although follicles were being produced on the side without a fallopian tube. The universe can be so cruel.

IVF is so physically and mentally traumatic with a tough drug regime and, sometimes, a daily transvaginal probe to root around for follicles. They found one follicle that may or may not have contained an egg on my first round of IVF after my drugs had been increased to the maximum dose.

We were advised to consider moving to the next stage of egg collection carefully due to the huge financial commitment and extremely low chance of having an egg within the follicle. I was also told that I had a significantly low chance of producing more eggs on future rounds of IVF.

I felt it was our only chance and that we had to go for it.”

Victoria

It was a no-brainer and our minds were already made up. We went for egg collection and, by some miracle, the embryologist in the next room shouted that I had one egg. I couldn’t believe it.

We went through the stressful wait to see if the egg fertilised and then stayed implanted. I had a positive pregnancy test four weeks later and now that single egg is my 15-year-old son. He’s my miracle child, as the odds were so stacked against us. My hormones must have been boosted after having him and I fell pregnant naturally a couple of years later. My daughter, who is now 13, is my second miracle baby!

Returning to work as a young mum with menopause symptoms

It was a few years after my daughter was born that the crippling night sweats started. They were horrific and the duvet would be soaked in sweat. I’d go from burning hot to freezing cold, even needing to shower during the night.

I’d returned to work and was managing hot flushes. They would come on while in board meetings in front of large groups of colleagues. I’d think, “Shit, I have a sweaty upper lip and my armpits are sweating.” The more I focused on it, the worse it got. I’d lose my words and get very embarrassed and overwhelmed. I remember wanting the ground to swallow me up.

My periods became erratic, my hair got thin and I had a cotton wool head where I couldn’t think clearly. My work started to suffer as I lost confidence and imposter syndrome set in. I couldn’t fathom what was happening to me.

The risks of early menopause

I knew something was wrong and I eventually saw a wonderful endocrinologist who asked me a really simple question, “Had anyone talked to me about menopause?” Up to this point, medical professionals had told me I was too young for menopause. That one question changed my life.

Blood tests confirmed I was menopausal. I started on HRT and it was like an elixir of amazingness. My symptoms stopped and I got some control back. I researched menopause and educated myself by reading articles and medical journals. I started to eat well and keep fit and healthy. I just wish I had been helped earlier in my menopause journey because the difference HRT made was life-changing. I have been taking it for 12 years and woe betide anyone who tells me to stop taking it!

Awareness of menopause is increasing but there is still work to do as premature ovarian insufficiency and early menopause are not talked about enough. No one talked to me about the side effects of early menopause and that I was at higher risk of osteoporosis and cardiovascular disease. Or why it is so crucial to replace declining hormones in my body by taking HRT and look after my health with good nutrition and supplements during menopause. Educating yourself about menopause is important so you understand what is happening with your body and so you can empower yourself.

The impact of POI and early menopause on relationships

Many people don’t give themselves credit for having busy lives, running a household, being a parent and working, plus trying to be the partner you’re meant to be. It doesn’t always work as you can’t always give your “full self” to everybody without a few casualties along the way. It was my marriage that gave way.

Looking back 10 years later with a clear head, I can see that a lot of my menopause symptoms impacted my relationship plus the myriad of emotions that IVF brings. But we all learn from our experiences, and that’s what life’s all about.

When you are going through fertility issues, you absolutely dread anyone close to you announcing they are pregnant. I have always been the life and soul of any party but I started to avoid social events as I was scared of my response if someone said they were pregnant.

I am extremely close to my sister and she became pregnant after my ectopic pregnancy. She should have been happy telling me she was pregnant but she cried because she was so worried about the effect it was going to have on me. I was ecstatic I was going to be an aunty but heartbroken for the baby I lost. It’s such a polarising set of emotions that many people just don’t have to think about. It is joyful that we both ended up being pregnant at the same time twice in the end.

What I wish I’d been told about my fertility options

I know I am bloody lucky. I have two gorgeous children, a loving partner, great friends and a beautiful family. Yes, I hit menopause early but that was my journey. I used to call my body a barren wasteland and make a joke out of it. It was my reality and how I viewed myself.

There is still grief there even though I have two stunning children. My body can’t have children anymore and I can’t have children with my new partner. I know I am more fortunate than a lot of people but you’ve got to come to terms with what’s going on with your body in your own way and in your own time. You deal with it and move forward.

I share my story to help women and young girls understand there are always options if fertility isn’t straightforward. Being told that you’re going through premature or early menopause is not the end of the road from a fertility journey point of view. There are always options and plenty of help out there. I want women and especially young girls to know they are not alone.

At the time I panicked I was never going to be a mum, as it was everything to me. It consumed me and I was fixated on giving birth myself. I wish someone had held my hand and explained that there were other options for me if I couldn’t have a biological baby or give birth. I could try a donor egg, surrogacy or adoption. Loving a child and being a parent is much more than giving birth. There is joy in many relationships and I am lucky enough to be a parent and a loving aunty.

Embracing motherhood is about nurturing and unconditionally loving another human and there are many ways to do that.”

Victoria

Also, there is just the simple relief of dealing with early menopause symptoms, taking HRT and feeling well again.

Read our guide to HRT risks and benefits.

Empowerment during IVF and early menopause

1 Advocate for your body and experience

Educate yourself about what’s happening to your body and read everything you can. Remember, no one knows your body like you do. If you think something isn’t quite right, be your own champion and continue to ask questions until you have the answers you need to alleviate your worries.

2 Focus on what your body can do and not what it can’t

You might put immense pressure on yourself or feel like a failure because you can’t produce a baby and that your body is letting you down. I didn’t credit my body for all the incredible things it was doing, like keeping me alive. I was fixated on my body as having just one purpose, to create a new life.

3 Say no when you need to

It is a normal reaction to dread other people’s news about their pregnancy. Be kind to yourself if you are feeling fragile. Of course, you are happy for your friends and family, but it is also a hard thing to hear if you’ve experienced your own emotional trauma or physical loss. People will understand if you need to do what is best for you.

4 Find those with similar experiences

You may feel isolated, vulnerable and scared as you don’t know what’s going to happen in the future. I share my story a lot at work within various forums and in conversations if it comes up.

I have had such immense and powerful responses when people have shared their own experiences, often with common themes and emotions. It is such an empowering mechanism to heal, help others and move forward. The power of women championing and listening to each other, and the solace it can bring never fails to amaze me.

Find out more about menopause on our blog or in our symptoms library.