Early Menopause: The Physical and Emotional Toll

June 22, 2012— -- Jackie Townsend hit menopause at age 23, "in the throes of a first love" that would crumble as hot dates gave way to hot flashes.

"I wasn't even thinking of kids," said Townsend, admitting she was more worried about her sex drive at the time. "You don't really think about fertility until you're in your late 20s, when you realize, 'This might be a problem.'"

For Townsend, a New York-based novelist, early menopause was the cost of a colon cancer cure. Despite her doctor's assurance that the cutting-edge chemo would preserve her fertility, her periods stopped -- ironically at the same time as her 50-year-old mother's.

"I remember both of us being so stoic about it… acting like nothing was wrong," said Townsend. "We never really confessed what was going on with the other."

Menopause, with its hot flashes, memory lapses and mood swings, is no walk in the park. But early menopause, also known as "premature ovarian failure," can take a heavy emotional toll, according to Sheryl Kingsberg, a psychologist specializing in women's health and fertility.

"We're talking about a woman who's not expecting to go through these changes," said Kingsberg, division chief of obstetrics and gynecology behavioral medicine at University Hospitals Case Medical Center in Cleveland. "It sort of ages her rapidly."

Beyond the shock of becoming "post-menopausal" while same-aged peers are starting families, the sudden drop in estrogen prompts wrinkles and plumps waistlines, Kingsberg said. It can also cause osteoporosis and "vulvovaginal atrophy" -- the thinning and drying of the vagina.

"The term alone is devastating to women," said Kingsberg, describing how the shrinking tissue also loses its sensitivity. "Early menopause is devastating in terms of fertility, sexual identity and self esteem."

For Townsend, menopause became a first-date ice breaker of sorts.

"When I met my [future] husband, I told him right away," she said.

Dr. James Grifo, director of reproductive endocrinology and infertility at the NYU Fertility Center in New York, said early menopause is hard to accept but easily managed.

"We can replace what the body stops making," he said, describing hormone replacement therapies that safely and effectively ease the symptoms of menopause. 'We use the same hormones the ovaries would be making at levels lower than those of ovulating women, and that resolves a lot of the symptoms."

Townsend, now 45, has been taking Prempro -- an estrogen and medroxyprogesterone tablet -- for 20 years. She and her husband decided not to have kids through egg donation or adoption, and instead revel in the company of their seven nieces and nephews.

"I have a great life," she said, adding that she's happy to have menopause behind her, rather than in front of her. "Now I get to watch my sisters go through it as they approach their fifties, and, perhaps, get a little retribution."