Personal and emotional impact of early menopause on women

A diagnosis of spontaneous or medically-induced early menopause (EM) or premature ovarian insufficiency (POI) (see Delivery of diagnosis and emotional impact of early menopause), and the symptoms (see Symptoms of early menopause) and treatments for EM/POI impact on other areas of women’s lives. The health practitioners we interviewed discussed the personal and emotional impacts that EM can have on women, including relationships, fertility, sexuality, body image, mental health and wellbeing, and cognition. The impact of EM/POI varies between women depending on her age, cause of menopause and other co-existing heath issues.

Dr Baber, a gynaecologist-obstetrician, shared his thoughts on how spontaneous EM (POI) affects women’s overall wellbeing.

General practitioner Dr Ee described how, in her experience, the emotional impact of EM and ‘natural’ menopause can be similar. 

Impact of EM on personal life

The impact of EM on women’s personal life can differ according to the cause of EM; whether it is spontaneous EM, or EM following cancer or medical treatment. For example, Dr P, a breast surgeon, commented that women who have an identified BRCA 1 or 2 gene mutation and undergo a risk reducing oophorectomy can be ‘euphoric’ because ‘many of them have been discussing having their ovaries out for the preceding decade’. However, medical oncologist Dr S remarked that EM is ‘an under-recognised and under-appreciated terrible symptom of cancer treatment’ and could be challenging for women to adjust to.

Health practitioners observed that the emotional impact of EM also depends on what supports women have in their personal life, their age, whether they had wanted children or have completed their families, and prior knowledge of EM. Dr C, an obstetrician-gynaecologist, said that in cases of ‘very early onset ovarian failure, there’s a lot of emotional impact on [women] and their families,’ particularly in relation to fertility (see Fertility and early menopause).

Endocrinologist Dr D discussed how the emotional impact of EM can vary between women, and depends on whether they have prior knowledge of EM.

When women are diagnosed with EM, they may feel ‘out of sync’ with friends and family members of similar ages and can find it difficult talking about their experiences. Dr Goeltom, a general practitioner, commented that women may experience a ‘psychological burden’ when diagnosed with EM (see Psychological therapies and support for early menopause): ‘You know you are different … [you think to yourself,] ‘Other women still have everything working, and not me’.’

Health practitioners observed that potential emotional impacts of EM include feelings of loss around youth, femininity, and/or fertility (see Fertility and early menopause). For Dr G, a clinical psychologist, those impacts are interconnected: ‘Women may have concerns around feelings of loss … questions around fertility and the plans that they had regarding a family… women talk about feeling a loss of their femininity, a loss of a feeling of youthfulness. A lot of women talk about feeling that they aged as a result of their early menopause’.

For Dr W, an endocrinologist, a general lack of awareness and understanding of EM can cause ‘stigma’ and body image issues, and make it difficult for women with EM to share their experiences.

Cognitive difficulties and impact on work

Several practitioners noted that women may report difficulties with concentration, memory and other aspects of cognition, which can be very distressing, especially if their work is also affected. However, it is difficult to say whether this is due to the EM/POI itself, the impact of menopausal symptoms on mood and sleep, the effects of treatments such as chemotherapy, or other factors.

Dr G, a clinical psychologist, shared her experience of working with women after chemotherapy, and discussed how cognitive difficulties can impact on women’s ability to work.

Emotional impact of EM due to cancer treatment

For women where EM/POI is a consequence of cancer treatment, the health practitioners we interviewed noted that the focus of initial consultations can often be on cancer, with issues related to EM being left for later consultations (see Telling women that cancer or medical treatment may cause early menopause). This can cause some women to feel that they cannot raise concerns about their experiences of EM. Health practitioners also commented that women may need additional support because of the combined impacts of EM and cancer treatment (see Non-hormone based medications for early menopause symptoms after oestrogen-sensitive cancers), particularly after their active treatment has ended.

Dr G, a clinical psychologist, explained how the emphasis others around them place on cancer can cause women to feel isolated in their experience of EM.

Ms Hay, a breast care nurse, described how during cancer treatment, some women need more support because of the combined impacts of EM and the treatment.

Impact of EM on intimacy

Health practitioners commented that women with EM may often experience difficulties in their sexual relationships. This may be due to the effects of EM, the effects of treatments (e.g. aromatase inhibitors or chemotherapy), issues related to body image, psychological distress and/or relationships (see Intimacy, sex and dating after early menopause (women’s experiences)).

Dr Goeltom, a general practitioner, shared her experience of discussing sexuality and relationships with her patients.

Several health practitioners explained that impact of EM on sexuality was an important topic to raise with women experiencing EM induced by cancer treatment because, as Dr G noted, ‘after cancer treatment, bodies change, and so what used to feel good in the past might not feel good now.’ Women may also find it difficult to talk about sexual function or vaginal or urinary symptoms with their health practitioner (see other resources below).

A breast surgeon, Dr P, emphasised the importance of building trust with patients to talk with them about the impact of EM on sexuality following cancer treatment.

Further information

Talking Points

Talking Points (women)

Other resources

Guidelines