Jenn’s blog: early menopause
Early menopause is a topic that comes up regularly in our community; the frustrations of trying to get adequate hormone replacement therapy and the pain and sadness of infertility.
The Pituitary gland releases gonadotropic hormones called Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH). These hormones stimulate the ovaries to release an egg and are an essential part of the monthly cycle. When the pituitary gland is damaged, this hormone feedback loop is broken and that's when early menopause arrives. You can read more about these hormones here: https://maternalpituitarysupport.org/oestrogen-progesterone
For me, early menopause arrived at age 28. I often describe it as a menopause cliff edge, because you're suddenly plunged into full menopause, with all the symptoms at once. This is whilst simultaneously looking after a newborn baby, recovering from a traumatic birth and dealing with any other hormones that have also been affected. As you can imagine, this is incredibly hard and you likely have no idea what is going on.
Whilst other new mums are gradually getting back to normal, you're a hot, sweaty mess; you can't remember a thing, you're consumed with anxiety and you secretly think you may be going mad. If this is you, you're not alone and it does get better.
There are often delays to starting oestrogen and progesterone replacement therapy (HRT). This might be whilst testing is carried out for other pituitary hormone deficiencies or waiting to see if periods return naturally. For me, it was 6 or 7 months before I started any oestrogen and progesterone. When I look back to that time, I wonder what those first precious months with my baby might had been like if I'd started HRT along with Hydrocortisone and Levothyroxine when I left hospital. You can read my story here: https://maternalpituitarysupport.org/news-blog/my-name-is-jenn-and-this-is-my-story
It was a huge shock at 28, to discover that I had early menopause. The doctors overseeing my care had with the kindest intentions, not told me that I was infertile until several months later. This was very hard to process.
I quickly realised that the system is not designed for anyone under the age of natural menopause. There seem to be no age appropriate guidelines for oestrogen or progesterone levels. The HRT initially offered to me was the contraceptive pill, or HRT treatments designed and dosed for much older women. I found the advice was inconsistent and disjointed. HRT may be out of stock or there are national shortages. Some doctors recommend sequential treatment, where you have a withdrawl bleed, like a monthly period. Others recommend moving onto continuous treatment, where no withdrawl bleed is needed. It’s difficult to know what’s right.
The HRT options are vast and confusing; tablets, patches, gels, foams, coils; all these become part of your new vocabulary. If you have adrenal insufficiency too, you might find out as I did that oral oestrogens can interfere with serum cortisol blood test results. If you try patches, you might find that they keep peeling up or falling off. I felt like HRT was a never ending project of trying to find what would work and stay available.
The good news is that menopause is now getting much more media attention. Doctors and celebrities are advocating for better treatment and awareness. Most GP surgeries have a doctor or specialist nurse with training in HRT. There are also specialist menopause services out there with Gynaeologists that work alongside Endocrinology.
It's taken almost 12 years, however I was fortunate to be seen in a specialist menopause service last year. I'm now on HRT replacement that is working for me; a mirena coil for progesterone along with oestrogen gel dosed for the needs of my body. I’m also prescribed Testosterone and local oestrogen. If you're in a similar situation, I'd suggest investigating a referral to a similar service in your area, or going to see a Gynaecologist who will communicate with your Endocrinologist.
Genitourinary Syndrome of Menopause (GSM) is a little known complication of menopause, but is vital to know about. I only found out about this thanks to a wonderful Ask The Expert event we had for our community a couple of years ago. If you've suffered from recurrent urinary tract infections (UTIs), vaginal dryness, pain during sex or recurrant yeast infections, you might like ask your doctor about local vaginal oestrogen. Find out more here https://thebms.org.uk/wp-content/uploads/2025/11/09-NEW-BMS-ConsensusStatement-Genitourinary-Syndrome-of-Menopause-GSM-NOV2025-B.pdf
It can feel very lonely navigating this journey and we want you to know you're not alone, there are others walking this path too and we can help each other along the way. Some families proceed with fertility treatment to have another baby too! You can read community member Andrea's uplifting story about having her second child here: https://maternalpituitarysupport.org/news-blog/and-then-we-were-four
As always, if you’re living with Sheehan’s Syndrome, Lymphocytic Hypophysitis, are seeking diagnosis, or are a mum with a different pituitary condition you are always welcome in our supportive community. www.maternalpituitarysupport.org/community