Premature menopause has no prevention and no cure so its diagnosis can be devastating. It affects between 1-6% of young women between the ages of 14-40. The following research article by Dani Singer highlights the complex psychological layers at risk for young women.
Premature menopause can represent a traumatic aspect of young woman’s life. The unexpected diagnosis can adversely affect her self-worth by attacking the sense of youthfulness, vitality, and sexual identity. So when diagnosed, the impact of premature menopause for young women can be difficult to initially absorb. Often what follows is the psychological adjustment and this is influenced by many factors. The study identified the following: a woman’s age, the cause, diagnosis delivery (the language used), the body language of the doctor, the information initially provided, follow up care plan and access to support. All of these dynamics will determine how well a young woman copes moving forward.
The author investigated young women’s experience (aged 19-39) in the diagnosing of premature menopause. The charted journey begins with the woman’s initial diagnosis, perception of cause, treatment received, key concerns, perceived long-term consequences and impact on psychological well-being. Singer examined survey result provided by 136 participants from across several menopause clinics within the UK.
Coping with the Initial Diagnosis
The study found many areas of common experience among women diagnosed with premature menopause that impact how they cope with their menopause. These include:
- How the news of the diagnosis is handled
The majority of the survey respondents felt the initial news regarding the diagnosis could have been handled better. The more satisfied patients reported the following:
- They were sensitively informed
- They were given the opportunity for questions
- They were given sufficient information and were able to schedule a follow up appointment
- How much and what type of information is given at the time of diagnosis
Survey respondents felt that there is a need for information tailored to young women and should include what to expect both in the short and long term.
- Whether the cause of premature menopause is known
If the cause of the premature menopause is unknown, the survey results indicate that the psychological impact of the diagnosis is worse.
Premature menopause is described by respondents as experiencing multiple losses. The study found those include the feeling of loss associated with the following:
- general health
- fertility/ reproductive function
- a sense of femininity
- quality of life
The survey results indicate that the younger the woman is when diagnosed, the more complex is her adjustment. The feeling of ageing prematurely was widely reported among the respondents.
The Need for Support
Women who are diagnosed with premature menopause need both medical and psychosocial support. In general, the survey respondents felt well cared for medically, although they report a lack of information regarding long-term use of HRT.
Psychosocial support in the early stages is important and helps to diminish the psychological symptoms (such as depression, anxiety, sleep problems and memory/concentration issues) related to a diagnosis of premature menopause. The following factors were found to impact survey respondents’ coping:
- Support from family, close friends, and/or partner
- Social group similarities, such as associating with people without children or with fertility issues
- Cultural issues
- Whether health professionals addressed the emotional aspect of premature menopause
When it came to seeking support about half of the respondents felt that support groups would be helpful. Others felt that support groups might make them feel worse.
Regarding counselling, only a third of respondents accessed counselling. The lack of counselling was due to either it not being offered or not being specialized enough. In general, a third of respondents who used counselling found it a helpful coping strategy.
The study also found that for a majority of the women, felt that their emotional health was negatively impacted by their premature menopause. These same women also agreed that counselling should be offered routinely and as soon as the diagnosis is made.
♥It is really important at the time of the diagnosis that healthcare providers offer information specifically on premature menopause.
♥Sensitivity is vital in diagnosis delivery as the impact can be negative; doctors need to be aware that the diagnosis leads to a feeling of loss and bereavement.
♥Fertility problems, especially in those who experience menopause very young, are not always an immediate concern. These women may need to follow up services, as fertility concerns may arise sometimes years after the diagnosis.
♥The type of psychological services is also important. Support groups can be either self-run or facilitated, and either virtual or real. Individual counselling may also be of benefit to young women.
Singer, D. (2012) It’s not supposed to be this way: Psychological aspects of premature menopause. Counselling and Psychotherapy Research, June 2012; 12(2): 100-108.