After their wedding in June 2017 and honeymoon in Tanzania that October, Holly Gurr and her husband, James, looked forward to the bliss of marriage. But instead, they learned that their future together wasn’t going to be what they had imagined.
Gurr, who lives in London, missed her period while in Tanzania. Though the couple wanted a baby, they planned to start trying after their honeymoon, so when she missed her period again in November, she knew something was wrong. She headed to the doctor, who did blood work. He said everything looked fine and attributed Gurr’s missed periods to the stress from her wedding or her up-and-down weight the previous year. Still, the doctor sent Gurr to a gynecologist for further testing.
It turned out that the first doctor had overlooked Gurr’s abnormally high level of follicle-stimulating hormone (FSH), which, her gynecologist told her, is a sign of menopause. “I’d never heard of menopause affecting someone so young,” says Gurr, who was 30 at the time. “It was such a shock.”
Gurr’s gynecologist later explained that she suffered from a condition called “primary ovarian insufficiency” (POI), a term doctors often use interchangeably — and inaccurately — with with “premature menopause.” “POI implies that there is the potential for some ovarian function to be there, and premature menopause implies that there is no possibility of the return of ovarian function,” explains Stephanie Faubion, MD, medical director for the North American Menopause Society and director of the Mayo Clinic Center for Women’s Health.
Whichever term a doctor uses, learning that you have only a 5 to 10% chance of getting pregnant at an age when all your friends are having children can lead to feelings of isolation, depression, and mourning. “It was devastating and life-changing,” Gurr says. “It has impacted every aspect of my husband’s and my life.”
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Going a year without a period is the official marker of menopause. Most women will start to experience perimenopausal symptoms such as hot flashes, irregular periods, vaginal dryness, and unexplained weight gain in their forties. Chemotherapy, radiation, and surgery to remove the ovaries can push a woman into premature menopause (before age 40) or early menopause (before age 45).
It’s unclear why the ovaries of young women like Gurr stop working. Theories include genetics, viral infections, and autoimmune diseases, explains Wen Shen, MD, assistant professor of gynecology and obstetrics at Johns Hopkins Medicine.
For women over 40 who are going through perimenopause (the time leading up to menopause), it’s pretty hard to miss the symptoms, especially hot flashes. But the estimated 1% of women with POI, who may experience some of the same symptoms as those who are perimenopausal, often write them off as stress of everyday life.
In hindsight, Gurr acknowledges that she experienced exhaustion, anxiety, dry skin, lighter periods, and difficulty losing weight for her wedding. But at the time she didn’t make anything of it. “I thought I was just stressed,” she says. “I didn’t listen to the signs — my body was trying to tell me something was wrong.”