Fertility, relationships and intimacy
If you were born without a uterus (womb) you will not be able to get pregnant or carry a baby.
Fertility
Your eggs can be removed and fertilised by your partner / donor’s sperm and then placed in another female’s (surrogate mother’s) uterus. This is known as IVF surrogacy and the baby will genetically be yours and your partner / donor’s.
This service is commonly available privately in recognised centres or clinics. It is possible to apply for part-funding from your GP so that you can have your fertility and IVF treatment completed on the NHS. Therefore, we advise that you and your partner discuss this further with your GP.
Your alternative fertility option is adoption and many of our couples have been successful in adopting children.
Menopause
What is the menopause?
The menopause is considered to be a natural life transition that most women including those with MRKH go through. It is also part of the aging process and when it occurs often women are facing other challenges in their lives. The menopause literally means the stopping of periods (meno=menstruation, pause=stop). The menopause occurs because the ovaries no longer produce eggs or the hormone oestrogen. Oestrogen is produced from a developing follicle in the ovary which contains the egg each month.
When does it happen?
We recognise that women with MRKH do not have periods so they will not have the signs that their periods have stopped. As women with MRKH have ovaries and all the hormones that go with them, they can feel and have the other symptoms of menopause like any other woman.
Studies suggest that the average age of menopause is 51 years of age. However, some women can go through the menopause at the age of 40, or even earlier.
What is the perimenopause?
The ovaries do not suddenly fail – there can be a gradual lowering of the amount of oestrogen produced in the months or years leading up to the menopause. This is known as the peri-menopause. During this time, some women may be sensitive to the reduced amounts of circulating hormones and start to notice their symptoms.
Premenopausal (perimenopause) symptoms can occur several months or years before the menopause. It is during this time that women may feel that things are changing, however, they may not fully understand what is actually happening. The symptoms are more often recognised in hindsight as women begin to enter the menopause.
Common menopausal symptoms
Menopausal symptoms vary widely. Some women do not experience any or have mild symptoms, whilst others may suffer severe symptoms. Symptoms can become more troublesome and harder to manage. The length of time these symptoms persist differs from woman to woman. Troublesome symptoms can also negatively impact women’s lives and may affect their relationships with their partner, family and work colleagues.
The main symptoms that women with MRKH may experience include:
- Hot flushes, skin reddening and sweating
- Tiredness, lack of energy
- Difficulty sleeping, night sweats
- Memory and concentration issues, “brain fog”
- Mood swings, low mood or anxiety, low libido
- Join stiffness, aches and pains
- Headaches
- Urinary tract infections (UTIs)
- Palpitations, noticeable heartbeats
- Vaginal dryness
We would encourage anyone that is suffering from symptoms that are affecting their daily life to have a conversation with their GP in the first instance. We are also here to help, so please do get in touch if you need additional support or if you would like to find out more about MRKH and the menopause.
How can people best support themselves?
If symptoms are particularly troublesome, we would encourage women to talk to their GP about how best these can be managed. In those with MRKH, blood tests may be performed to assess hormone levels. If symptoms are attributed to menopause or perimenopause, various options for treatment can be discussed. These include lifestyle measures, exercise, psychological support and medication known as hormone replacement therapy or ‘’HRT’’.
HRT can be considered for those who have troublesome or more severe symptoms. HRT may not relieve all symptoms and the side effects of HRT may also cause issues for some individuals. Where this is the case additional support may be required. It is also important to say that HRT may not be an option if there are any medical issues or a family history which make the use of HRT inadvisable.
Most women who do not have a womb/uterus only need to take oestrogen HRT. They do not need to take progesterone as well, as this is only necessary to protect the lining of the womb. This can be an advantage as some women have side effects from progesterone and the risks of breast cancer are reduced in oestrogen-only treatments.
However, some women with MRKH have functional womb buds (anlage), which gives them monthly abdominal pain. If you have these conditions, you will require progesterone in addition to oestrogen as part of your HRT regime to prevent activation and recurrence of pain.
Medication is not the only thing that can help. We would also recommend taking some time to research to find out how exercise, diet, meditation and relaxation can support your overall wellbeing. All women should ensure they always eat a healthy, well-balanced diet, drink plenty of water and take regular exercise. After the menopause, weight-bearing exercise and adequate calcium in the diet is helpful for bone strength. Calcium supplements can be taken, especially if your diet is low in dairy products.
Cognitive behavioural therapies are known to be beneficial and non-hormonal treatment options are also available. Having someone to talk things through with is beneficial and coaching is one way to do this. Coaching offers a confidential space with someone who truly listens, someone who can support you around menopause as well as help you navigate the changes and challenges in your life, so that you can remain control.
If you would like to find out more about MRKH and the menopause, or if you think you are having troublesome symptoms do get in touch and email us on enquiries.drd@nhs.net
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