What It’s Like To Be In Menopause In Your 30s (Just Like Angelina Jolie)
After Angelina Jolie revealed that she had her ovaries and fallopian tubes removed after a cancer scare, we asked women who underwent the same procedure to tell us what it’s really like. (Photo: Corbis)
Deborah Lindner, MD, was a fourth-year resident at Northwestern University when she learned she had the BRCA1 mutation, meaning her lifetime risk of developing breast or ovarian cancer is much higher than the average woman’s.
Then her mother was diagnosed with breast cancer. Soon after, her grandmother was diagnosed with ovarian cancer. On the personal side, she watched them both go through chemotherapy and all the associated symptoms; on the professional, as she was became a practicing OBGYN, she saw women go through similar experiences as a doctor.
They were all treating the disease after it was roaring through their bodies.
Lindner remembers assessing her own odds of avoiding a cancer encounter, and turned her attention to prevention. “My risk of breast cancer alone was 87 percent,” she tells Yahoo Health. “For me, it really wasn’t a matter of ‘if,’ but of ‘when’— and I remember thinking that I didn’t want to go through chemo.”
At age 33, Lindner had a double mastectomy. She met her husband at age 37. Within a year, they had their first child. Fourteen months later, she gave birth to her second. Immediately following, she scheduled surgery to have her ovaries taken out.
“Ovarian cancer is more difficult to treat and catch — it’s more deadly,” Lindner says. “I really felt like there wasn’t an option to not get the surgery. It was really just a matter of having my kids.”
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One month before her 40th birthday, Lindner had her ovaries and fallopian tubes removed. The surgery throws the body into an immediate state of forced menopause; Angelina Jolie just revealed she had this procedure last week in an op/ed piece for The New York Times.
Lindner couldn’t be happier with her decision, though. “Angelina alluded to being ready for it to be difficult,” she says. “But for me, it’s not that bad. I take hormones. I don’t feel the lack of ovaries in my body, and I don’t have hot flashes. It’s remarkable that we have such amazing medical treatment today.”
At 50, Lindner plans to stop taking the hormones she’s currently on to replace the ones her ovary would have provided her to roughly that age. “At that point, I’ll probably go through more of the menopausal symptoms I would have had anyway,” she says. “But for me, the most difficult part is remembering to take the hormones. They come in a one-month supply, and if you miss a dose, you will feel it.”
Like Lindner, pediatrician Laura Schwab, MD, also chose to have her ovaries and fallopian tubes removed, but had a very different path to discovery. “My father was diagnosed with late-stage stomach cancer in 2012,” she tells Yahoo Health. “ A month after finding out he had the BRCA2 mutation, he passed away — but it prompted Schwab to get tested, and she discovered she had this mutation, as well.
Schwab immediately met with a genetic counselor to discuss her risks. With the BRCA2 mutation, the lifetime odds of developing ovarian cancer jump from 1.4 percent to around 11 to 17 percent. “Since I was done having kids, I knew it was time to get my ovaries out,” she says. “It was an easy decision, especially since it is so hard to detect. Everyone in my family had been through so much. I felt it was the silver lining behind my dad’s illness.”
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At age 41, Schwab entered menopause overnight. But unlike most women, she chose not to utilize hormone replacement. “A lot of women fear menopause, but my doctor and I chose to manage the symptoms systematically as they developed,” she says. “I had hot flashes, but we figured out a treatment that worked.”
Not everyone is as lucky, since hormone-replacement therapy has risks, like blood clots, and, like Schwab, not all women go that route immediately. Alicia Sanchez, a 29-year-old clothing designer, underwent a full hysterectomy (removal of the ovaries, fallopian tubes and uterus) after tumors and cysts were producing severe menstrual problems.
She has wanted to hold off on hormone replacement, for the most part, due to concerns about safety. However, she has struggled to manage her symptoms in their absence two years post-surgery. “The hot flashes came immediately, the day after surgery,” she says. “At first, it wasn’t as frequent, but now it feels as if I’m in a sauna for 30 seconds, and I sweat like crazy. I carry cold patches with me.”
Sanchez has also suffered from a low sex drive, making relationships difficult to maintain, but has found positivity in her current situation. “I only get sad because I want children so badly, but I realized all children in the world can be mine,” she says. “Out of my depression, I opened a school for kids’ fashion design and sewing. …Which I can leave to children worldwide.”
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Writer and filmmaker Carole Keeney Harrington of Houston, TX also had a full hysterectomy at age 43, and lapsed into a depression after the first go at hormone replacement left her with a queasy stomach and doctors tried other avenues for symptom control. “I quit my job as a journalist for a major newspaper, work that I loved, because I could no longer function, which made me even more depressed,” she tells Yahoo Health.
Finding the right doctor to work with her on a suitable course of treatment has helped Harrington dramatically. “My doctor told me I had virtually no hormones [when I initially saw her],” she says. “My body had gone into a tailspin without the proper monitoring by an endocrinologist. She put me on the 1.0 hormone patch, which I have been using now for many years. My advice is to line up the best endocrinologist you can find before you embark on this surgery.”
The right doctor really can make all the difference. Organizing consultant Julie Moon, a 37-year mother of three from Athens, GA, had her concerns about surgery options after finding out she was BRCA1 positive at age 30. With a family history of breast cancer, she underwent a bilateral mastectomy soon after, but wasn’t yet sure about surgery to remove both her ovaries and fallopian tubes.
“I was 35, and I continued to do research” she says. “It felt like an intense decision at that age, because of the potential effects on bone density, the risks of heart disease, and the hormones.”
However, Moon had a doctor who was willing to dig into the research with her. “She sent me a study about women who were just having their fallopian tubes removed,” she says. “Obviously, this is all super-new research, but there’s evidence that a lot of cancers seem to start there.”
She decided to go this route at the suggestion of her doctor. At 37, she no longer has fallopian tubes, but she still has her ovaries. “It was a super-easy procedure, and the recovery was very minimal,” Moon explains. “I think a lot of women don’t know how their bodies work in this regard. You have a regular cycle, you just don’t pass eggs. It’s a similar effect to having your tubes tied.”
Moon plans to have her ovaries removed within the next few years. For now, she’s monitoring her CA-125 levels annually, a test used to measure potential risk of ovarian cancer. “I feel concerned not knowing about that cancer, but it’s really weighing the benefits versus the risks at this point,” she says. “My biggest concern with the removal of my ovaries is that your body basically thinks it’s a lot older than it is. Bone loss and heart issues can happen if you don’t take hormones, and even then, they’re artificial. To me, at least, that does not seem as good as what God gave us naturally. It’s not ideal.”
However, the procedure isn’t a question. “I’m definitely having them out,” Moon says. “My doctor is measuring my levels as I approach 40, to see if and when I am producing less and less hormone, and then I’ll lose my ovaries at that time. My body will probably respond in a more natural and healthy way.”
It’s hard to predict an individual’s response, but some do very well. Schwab says the most difficult part of the surgeries was the recovery. “I also had a hysterectomy, and I couldn’t pick up my son right away, who was just one,” she says. “There was also the hormone change — but I trust my doctors, and I felt comfortable knowing those changes were going to end. Whether you are on hormone replacement or using other treatments to manage those symptoms, surgical menopause is deal-able and your doctors can help you get through that.”
Would she do it again? “100 percent,” Schwab says. “In a heartbeat.” She just wishes she would have been screened sooner. “Half of those people with a BRCA mutation don’t have a family history of breast or ovarian cancer. If I would have been screened at 30, then I can dream that maybe my dad would have been screened and his cancer would have been picked up at an earlier stage.”
Lindner also has a different way of looking at her experience than most. “My mother is a 25-year breast cancer survivor now, and my grandmother is a 15-year ovarian cancer survivor — which is amazing,” she says. “But despite how wonderful that is, they both still have to think and worry about a recurrence of their cancers.”
She says she can’t encourage women enough to examine their risks and learn what options they have. Lindner works with the organization Bright Pink, dedicated to education and awareness about breast and ovarian health, and helped develop the Assess Your Risk tool to easily help determine a woman’s relative risk of these cancers.
Lindner wants women to get tested, and and not fear knowing whether they carry a genetic mutation. “My resounding opinion about the BCRA mutation is that it’s a gift,” she says. “I knew my risk. My grandmother didn’t have that ability, because they hadn’t identified this gene yet. And along with that gift, I have options.”
“I like to face problems,” she continues. “And when I knew I had the mutation, I knew I could be a powerful advocate for my own health. I am no less of a woman or human being based on my surgeries.”
