Age at interview: 50
Diagnosis: Spontaneous Premature Ovarian Insufficiency (POI)
Age at diagnosis: 30
Background: Ella works part-time in the health sector, and lives in a regional town. She is from an Australian background.
About Ella: Ella first experienced menopausal symptoms when she was 17, and irregular menstrual periods throughout her 20s. She saw various doctors, some of whom thought she had Premature Ovarian Insufficiency (POI), and others who thought she was missing periods because of stress. At 30 Ella was diagnosed with POI, and prescribed Hormone Replacement Therapy (HRT). However, she found HRT difficult to tolerate and stopped taking it in her late 30s. Ella no longer experiences menopausal symptoms.
More about Ella: Ella first experienced hot flushes and fatigue in Year 11. After she started missing menstrual periods and experiencing depression at university, she saw a doctor, who advised her that her symptoms were a sign of ‘stress.’
After university, Ella moved overseas for ten years. During this time, she consulted several doctors on visits back to Australia about the fact that she didn’t ‘really have periods,’ but received varying advice as to whether she was experiencing Premature Ovarian Insufficiency (POI) or stress. Finally, at age 30, a specialist diagnosed Ella with POI, telling her that ‘not everything is due to stress.’ Although she hadn’t ‘wanted to hear [she] was menopausal,’ the diagnosis was also a ‘relief.’
Ella was then referred to an IVF clinic, and advised that if she wished to have a child she would need a donor egg. She was placed on a waiting list, but heard nothing, and didn’t make any further enquiries. Looking back, Ella thinks her lack of ‘follow up’ was because she was single at the time, and was reluctant to use donor sperm, having grown up without a father herself.
To protect her bone health, Ella was initially prescribed the pill, which she ‘couldn’t tolerate,’ then HRT. However, after starting HRT she said she began experiencing a lot of ‘anger,’ ‘mood swings,’ and acne. Ella tried different doses and forms of HRT, but in her late 30s decided to stop taking it because of the side-effects she experienced. Instead, she asked her GP to coordinate her care and monitor her bone density. Ella is happy with her GP, but feels her other health conditions, including fibromyalgia and depression, mean POI sometimes ‘drops off the radar.’
For many years, Ella recalled feeling ‘ashamed’ about having POI, and ‘hid it’ from everyone but her mother and sister. She recalled being worried that, as she lived in a small town, if she told friends, ‘everyone would then know.’ However, recently Ella has become more ‘open’ about her experience, particularly as her peers have started going through menopause.
Although Ella isn’t sure she ‘really’ wanted children, she feels that not having any has had a ‘profound’ effect on her life. Living in a regional area, she has found it difficult to meet many women her age who are not ‘busy’ with ‘family obligations.’ Walking her dog has helped her meet other single women, and she is now doing postdoctoral studies part-time. Ella advises other women with POI to keep searching until you find a doctor who ‘believes’ you and is ‘understanding.’
 Use of HRT until the natural age of menopause (51 years) is recommended for women with spontaneous POI for menopausal symptoms as well as bone and heart health, unless there is a medical reason not to take oestrogen, e.g. women with personal experience of breast cancer, or who experience side-effects they cannot tolerate.