Menopause in the teenage years

Elizabeth Banks, an art-and-design student now aged 22, started her periods on her 11th birthday and had only seven more until she reached 13, when they stopped.

She was not worried about this and neither was her mother, who was sure they would start again, as teenagers' cycles are typically erratic. However, when she began to have hot flushes at 15 she knew deep down that something was terribly wrong. "I often joked that I seemed to be going through the menopause despite the fact that I told myself I was so hot because I was overweight. But I knew I was different from everyone else and despite frequent visits to the doctor it was not until I was 17 that I had my hormone levels tested. The gynaecologist was most insensitive when she broke the news to my mother.

She said, 'Premature menopause, infertility, osteoporosis, start taking HRT now,' and that was that. Mum and I were in a state of utter shock and disbelief."

Elizabeth, who should have been worrying about contraception, not the fact that she had been told she could never conceive, felt dreadfully confused. "Could I ever regard myself as a real woman? I worried about boyfriends. Surely they would be put off at the thought of an infertile, menopausal woman when they wanted a young lover?

"Oddly, they seemed to take it in their stride. They'd say things like, 'At least we don't have to worry about you getting pregnant.' I hated the whole idea of HRT, yet after about six months I realised that I had to take hormones to protect my health and alleviate the hot flushes, which I was having regularly. I started university not knowing whether I was a teenager or a middle-aged woman."

Susan Thomas's story is similar. Now 36, she started her periods at 12, had two more and then they stopped. She developed normally in every other respect but, unlike Elizabeth, had no menopausal symptoms. Because her doctor had never previously treated a menopausal teenager he assumed that her periods would return and it was not until Susan was at college, at 18, that he referred her to be examined internally with an endoscope - a tiny telescopic camera. "The gynaecologist said that my ovaries had shrunk and my organs looked infantile," says Susan. "Thankfully, she was most sympathetic and took me aside to explain that this condition could not be reversed and I would now need HRT. There was no answer as to why this had happened. I went back to college on HRT, feeling extremely depressed. I put on weight immediately. I would stop taking HRT for long periods of time and feel fine. But when I went into teaching at 22, I started getting constant hot flushes and feeling exhausted - now I couldn't deny what was happening.

"I felt so isolated. There was a distinct lack of interest from the doctors who simply said, 'Just keep taking HRT.' I persevered and my body settled down to an extent, but I had very bad mood swings. I'd always wanted to have children so very much. Everything seemed to get on top of me. My mother struggled to come to terms with the fact that I was having my menopause before her."

Susan married at 22; her husband, Keith, knew that it was unlikely they would have children. Susan was desperate to conceive, but a request for egg-donor IVF was dismissed out of hand, and it was not until she was 30 that she felt able to seek another opinion. "A wonderful doctor said it was precisely women like me who could benefit from the treatment. My first IVF was successful. Once the egg was implanted in my womb the pregnancy was the same as any other. I had to take hormones to support the pregnancy, of course. My second treatment was also successful. My two children, Oliver and Chiara, who are now five and one, are healthy and beautiful. So, apart from the fact that I have to stay on the HRT patches to guard against osteoporosis and heart disease, I am a happy, normal mum."

Elizabeth is more fatalistic but none the less positive about the future. "Right now, I feel I'm too young to worry about having children, but I know that I will not want to try egg donation, for moral reasons. Even before I knew I couldn't conceive, my view was that if I couldn't have children, it was meant to be. I'd rather adopt. For now, I'm going to concentrate on passing my exams and getting on with a life as normal as possible."

Send an SAE to: Daisy Network (premature menopause), PO Box 392, High Wycombe, HP15 7SH.

National Gamete Donation Trust (information on egg donors): PO Box 82, Bury, Lancs BLO 9GE (01706 829428).

The Menopause, HRT and You by Caroline Hawkridge (Penguin, £7.99), covers the subject of teenage menopause (the author went through a premature menopause herself).