|
When Maureen Doherty and her husband got married, she was in her 30s. They were eager to have kids, maybe even a bunch. When she went off the pill at 36 and didn’t get pregnant right away, she didn’t worry much. Her doctor did a few blood tests, just to make sure everything was working fine. But it wasn’t. Doherty got the results in a phone call from a physician’s assistant. Doherty: I’m sitting at my desk at work one day, and she calls me and she says to me, ‘I have a little bit of bad news. You’re post-menopausal.’ Being past fertility was not news the couple had expected. Doherty says reality hit when she was on her way home that night. Doherty: I can still remember sitting on the bus and thinking, I’m probably not going to have children. And to hear that, you know, four months after you’re married, it was heartbreaking. She soon learn she has primary ovarian insufficiency, or POI. One in 100 women develop the condition by the age of 40. Unlike true menopause, which ends periods and ovulation, POI is trickier. It can come and go. A few women get pregnant. But others who may have missed a few periods in a row, and chalk it up to stress, actually have POI and don’t know it. The cause: usually unknown. Dr. Lawrence Nelson studies and treats young women with POI at the National Institutes of Health. He says his patients are often shocked that irregular periods can be a big deal. Dr. Lawrence Nelson: There’s this disconnect. The menstrual cycle is just seen more of – as a nuisance. But actually, it’s the sign that the ovaries and the whole endocrine system related to the reproductive system is working the way it should. Looking back, Maureen Doherty realizes there were signs her hormones were off by her early 30s. She had hot flashes now and again. Doherty: A lot of times, I would be out with friends and I would say: Are you guys hot? And they’d say, no, not at all. And I would think: How could they not be hot? Because I am dying here. But each surge of heat only lasted a minute or two, so she dismissed it.Around that time, her periods also became a little less predictable. Doherty: I’d have one one month, not the other. And so I just – I mentioned this to the doctor, and she just shrugged and immediately gave me a prescription for birth control. Putting a young woman on the pill to even out her monthly cycles is very common, Nelson says. But doctors should be ruling out underlying problems first. Dr. Nelson: It might be reassuring to women – oh, it looks like things are fine now because my periods are coming. But in fact, their ovaries are not supplying the hormones to make that happen, so it’s masking the fact that their ovaries aren’t working normally. Ovaries that aren’t working don’t produce enough estrogen. And when that happens early in life, the damage can go beyond fertility to also affect bones. Dr. Nelson: The wake-up call we got was about 10 years ago, where we had twin sisters come to see us in our program, at age 23. They both had bone densities of a 77-year-old woman. Turns out, Nelson says, the twins had menstrual problems during adolescence that were never evaluated. They could’ve grown up with healthy bones, he says, if they’d been prescribed a patch to supply the missing estrogen and progesterone to balance it. For now, there’s still no way to reverse POI’s effect on fertility. But Nelson has new research hinting that most of these women might yet be capable of producing viable eggs. 2010-07-27
|
