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Women's Experiences of Diagnosis and Treatment of Early Menopause and Premature Ovarian Insufficiency: A Qualitative StudyFunding Information This study was funded by a NHMRC Partnership Grant (number: APP 1116008) and a National Breast Cancer Foundation grant (number: PE-16-002).
Early menopause (EM) and premature ovarian insufficiency (POI) affect an estimated 10% of women and can precipitate a wide range of physiological and personal impacts. Receiving a diagnosis of EM/POI and navigating treatment can be complex experiences for women; however, qualitative research exploring these aspects of the condition is limited. Our study aimed to increase understanding of women's lived experiences of EM/POI encompassing its medical, social, and emotional dimensions. We conducted narrative interviews with 30 women aged 28 to 51 years with spontaneous and iatrogenic EM/POI and menopausal symptoms resulting from ovarian suppression therapy, and analyzed transcripts thematically. This article examines the prominent and under-researched themes of women's experiences of navigating “diagnosis” and treatment. Diagnosis emerged as a complex and changeable process wherein women had to negotiate a diagnosis of spontaneous EM/POI and grasp the meaning and probability of iatrogenic EM/POI. Navigating treatment entailed further complexity as women grappled with the risks and efficacy of hormonal and non-hormonal medications. The findings underline the intricacies of EM/POI as a biomedical phenomenon and highlight the need for health practitioners to recognize and respond to the challenges women face in coming to terms with the condition and managing its embodied effects.
Keywordsdiagnosis - early menopause - premature ovarian insufficiency - qualitative research - treatment
20 January 2021 (online)
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- 1 Faubion SS, Kuhle CL, Shuster LT, Rocca WA. Long-term health consequences of premature or early menopause and considerations for management. Climacteric 2015; 18 (04) 483-491
- 2 Singer D. 'It's not supposed to be this way': psychological aspects of a premature menopause. Couns Psychother Res 2012; 12: 100-108
- 3 Parton C, Ussher JM, Perz J. Experiencing menopause in the context of cancer: women's constructions of gendered subjectivities. Psychol Health 2017; 32 (09) 1109-1126
- 4 Johnston-Ataata K, Flore J, Kokanović R. et al. 'My relationships have changed because I've changed': biographical disruption, personal relationships and the formation of an early menopausal subjectivity. Sociol Health Illn 2020; 42 (07) 1516-1531
- 5 Deeks AA, Gibson-Helm M, Teede H, Vincent A. Premature menopause: a comprehensive understanding of psychosocial aspects. Climacteric 2011; 14 (05) 565-572
- 6 Howard-Anderson J, Ganz PA, Bower JE, Stanton AL. Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst 2012; 104 (05) 386-405
- 7 Parton CM, Ussher JM, Perz J. Women's construction of embodiment and the abject sexual body after cancer. Qual Health Res 2016; 26 (04) 490-503
- 8 Perz J, Ussher J, Gilbert E. Loss, uncertainty, or acceptance: subjective experience of changes to fertility after breast cancer. Eur J Cancer Care (Engl) 2014; 23 (04) 514-522
- 9 Pearce G, Thøgersen-Ntoumani C, Duda JL, McKenna J. Changing bodies: Experiences of women who have undergone a surgically induced menopause. Qual Health Res 2014; 24 (06) 738-748
- 10 Boughton M, Halliday L. A challenge to the menopause stereotype: young Australian women's reflections of 'being diagnosed' as menopausal. Health Soc Care Community 2008; 16 (06) 565-572
- 11 Thewes B, Meiser B, Taylor A. et al. Fertility- and menopause-related information needs of younger women with a diagnosis of early breast cancer. J Clin Oncol 2005; 23 (22) 5155-5165
- 12 Burrell B, Valledor V, Crowe M, Whitehead L. Negotiating competing discourses: the decision to take menopausal hormone therapy following surgical menopause. Women Health 2010; 50 (06) 527-543
- 13 Yeganeh L, Johnston-Ataata K, Vincent A. et al. Co-designing an early menopause digital resource: model for interdisciplinary knowledge translation. Semin Reprod Med 2020
- 14 Yeganeh L, Boyle JA, Gibson-Helm M, Teede H, Vincent AJ. Women's perspectives of early menopause: development of a word cloud. Climacteric 2020; 23 (04) 417-420
- 15 Anderson DJ, Yates P, McCarthy A. et al. Younger and older women's concerns about menopause after breast cancer. Eur J Cancer Care (Engl) 2011; 20 (06) 785-794
- 16 Connell S, Patterson C, Newman B. A qualitative analysis of reproductive issues raised by young Australian women with breast cancer. Health Care Women Int 2006; 27 (01) 94-110
- 17 Knobf MT. “Coming to grips” with chemotherapy-induced premature menopause. Health Care Women Int 2008; 29 (04) 384-399
- 18 Halliday L, Boughton M. Premature menopause: exploring the experience through online communication. Nurs Health Sci 2009; 11 (01) 17-22
- 19 European Society of Human Reproduction and Embryology. Information for women with Premature Ovarian Insufficiency Grimbergen. 2016 . Accessed August 23, 2020 at: https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Management-of-premature-ovarian-insufficiency
- 20 Gibson-Helm M, Teede H, Vincent A. Symptoms, health behavior and understanding of menopause therapy in women with premature menopause. Climacteric 2014; 17 (06) 666-673
- 21 Singer D, Hunter M. The experience of premature menopause: a thematic discourse analysis. J Reprod Infant Psychol 1999; 17 (01) 63-81
- 22 Knobf MT. Carrying on: the experience of premature menopause in women with early stage breast cancer. Nurs Res 2002; 51 (01) 9-17
- 23 Squire C. Experience-centred and culturally-oriented approaches to narrative. In: Andrews M, Squire C, Tamboukou M. eds. Doing Narrative Research. London: Sage; 2008: 42-63
- 24 Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis?. Qual Res Psychol 2020; DOI: 10.1080/14780887.2020.1769238.
- 25 Jutel AG. Putting a Name to it: Diagnosis in Contemporary Society. Baltimore, MD: Johns Hopkins University Press; 2011
- 26 Jutel AG. “The news is not altogether comforting”: fiction and the diagnostic moment. Perspect Biol Med 2016; 59 (03) 399-412
- 27 McDowell L. Post-crisis: youth, identity, class and gender. In: Furlong A. ed. Routledge Handbook of Youth and Young Adulthood. 2nd ed.. Routledge; 2017: 50-57
- 28 Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Lancet 2019; 394 (10204): 1159-1168
- 29 Griffiths F. Women’s control and choice regarding HRT. Soc Sci Med 1999; 49 (04) 469-482
- 30 Reece SM. Weighing the cons and pros: women's reasons for discontinuing hormone replacement therapy. Health Care Women Int 2002; 23 (01) 19-32
- 31 Stephens C, Budge RC, Carryer J. What is this thing called hormone replacement therapy? Discursive construction of medication in situated practice. Qual Health Res 2002; 12 (03) 347-359
- 32 Thompson JJ, Ritenbaugh C, Nichter M. Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making. BMC Womens Health 2017; 17 (01) 97-18
- 33 Hoffmann PL, Lotta LA, Kjellgren K. Risk talk: rhetorical strategies in consultations on hormone replacement therapy. Health Risk Soc 2003; 5 (02) 139-154