At the age of 27, I missed my period.

"I'm still young. Taking some medicine will make me better."

"Ovarian function decline."

In 2018, 26-year-old Yuan Yuan looked at these six words on the diagnosis report without any concept.

Before this, Yuan Yuan's menstruation had been irregular for some time. Since 2017, she either had her period twice a month or once every two months. At that time, Yuan Yuan also went to the local maternal and child health hospital for an examination. The doctor told her it was just menstrual disorder and that taking some progesterone would be fine. But it didn't work after taking it for a few weeks.

It wasn't until May 2018 that, on the advice of an acquaintance, 26-year-old Yuan Yuan came to this health center. She had examinations for six items of sex hormones and the AMH value (i.e., anti-Müllerian hormone, an indicator to measure ovarian reserve function). The indicators were all very poor. Even her AMH was only 0.01 - the normal range for adult women should be between 2 and 6.8 ng/mL. The lower the value, the worse the ovarian function.

The doctor didn't explain what kind of disease this was. He only told her that she might not be able to have children and tried to comfort her by saying that his classmate had lost a child and "now the couple is living a good life." He also told her that there were still follicles and she should have a chance of getting pregnant. "Maybe the doctor thought I was young and didn't want to say too many serious things for fear of discouraging me," Yuan Yuan thought.

The doctor prescribed Femoston and Progynova for her to supplement estrogen. But Yuan Yuan started to resist after taking them a few times. She was worried about gaining weight, and she felt nauseous and wanted to vomit every time she took them. In 2019, she stopped taking the hormonal drugs on her own and tried to improve her condition with traditional Chinese medicine, but it was also ineffective. For the longest time, she didn't have her period for three months and had symptoms such as tinnitus, difficulty falling asleep, and hot flashes.

At the age of 27, Yuan Yuan went to that health center again. This time, the doctor directly diagnosed her with premature ovarian failure and advised Yuan Yuan to have children early if she wanted to, otherwise, the condition of her ovaries would get worse.

Premature ovarian failure, or "primary ovarian insufficiency," refers to the premature decline of ovarian function in women before the age of 40. In addition to sex hormone levels and AMH values, clinical symptoms are also important indicators for diagnosing premature ovarian failure. And not having a period for more than three months is a typical symptom.

In fact, few girls regard not having a period as a manifestation of a certain disease. In their view, not having a period is mostly due to high stress.

This is the case for 35-year-old Liu Le. During the Spring Festival in 2022, she found that her menstrual flow suddenly decreased, only a few drops each time, and the cycle changed from 30 days to 40 days. Before that, her menstrual flow was so heavy that she had to use night-time sanitary pads of 330mm length during the day. At first, she didn't take it seriously. After all, whenever she had high work stress before, her menstruation would be irregular and have short-term disruptions.

It wasn't until half a year later that a colleague who wanted a second child said she was going to see a traditional Chinese medicine doctor. Liu Le, who also had a plan for a second child, went with her. They made an appointment with a gynecological expert and had tests for six items of gonadal hormones and AMH. After the results came out, the old traditional Chinese medicine doctor who looked at least 60 years old looked at Liu Le's indicators and said earnestly, "Your current hormone level is even lower than mine."

But Liu Le didn't take it to heart and thought it was all reversible. "I'm still young. As long as I go back and replenish my body and take some medicine, I'll be fine." The doctor prescribed a bottle of Dingkun Pills for Liu Le to see how it worked.

But Liu Le had the same situation as Yuan Yuan. First, her menstrual flow became less and less. Until July 2023, Liu Le stopped having her period. Then, there were a series of physical discomforts - backache, weakness in her legs, and she felt like she was carrying a turtle shell on her back every day.

Four months after her period stopped, Liu Le couldn't stand it anymore. She made an appointment with a Western medicine doctor locally. The doctor prescribed a box of Femoston for her and said she could take it for a month first to help her supplement estrogen and progesterone through the medicine and regulate her menstruation.

That day when she got home, Liu Le searched for some information about Femoston online and learned that she might have to take this medicine until the age of 45 (the minimum age in the normal range of menopause for women). She didn't believe it and thought she "was still young and there was still hope." Seeing that netizens recommended a traditional Chinese medicine gynecological expert in Beijing who was good at treating amenorrhea caused by female reproductive endocrine disorders, she decided to go to Beijing to give it a try.

In Beijing, Liu Le was first "sentenced" to have premature ovarian failure. The doctor said that for some people, it was caused by genetics, and for others, it was due to uncontrollable factors such as mental stimulation and autoimmune diseases. At the same time, the doctor told Liu Le that this disease was irreversible. Liu Le didn't believe it, but the doctor advised her, "It's hopeless. Don't waste your money anymore."

Liu Le had no choice but to go home obediently and take Femoston. But she still had a glimmer of hope in her heart. "I didn't fully accept this fact psychologically because I thought I was too young."

Indeed, almost every young person questions the diagnosis of premature ovarian failure at the first moment. "Isn't this a disease that only people in their forties get?" "Isn't irregular menstruation a very normal thing?"

Some even get angry and furious when they hear the words "premature ovarian failure" because they can't accept it. Shi Qi, a resident doctor in the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital, told "The Wave Research Institute" that in the outpatient department where she worked, there was once a patient who couldn't accept her diagnosis of premature ovarian failure and complained about the department.

Daily Life Controlled by Hormones

In fact, it's not a rare thing to be diagnosed with premature ovarian failure at the age of 30.

Shi Qi can clearly feel that in recent years, the number of patients under 30 who are diagnosed with premature ovarian failure has been increasing. Fortunately, overall, the proportion of patients in this age group among those with premature ovarian failure is not that high - ranging from 5% to 15%. Shi Qi thinks this is related to the current diet structure and living pressure of young people.

Shi Qi once received a 26-year-old patient who didn't have her period for eight months because of weight loss and was finally diagnosed with premature ovarian failure. This is not an isolated case. She has seen many women in clinical practice who have had amenorrhea for half a year or even a year, and the initial factor was rapid weight loss, which led to their body fat content dropping too low. "The estrogen in our body is synthesized from cholesterol in our body, and cholesterol is a type of lipid. So our lipid metabolism is closely related to the synthesis of estrogen," Shi Qi said.

On the other hand, excessive stress can interfere with the hormone secretion of the hypothalamic - pituitary - ovarian axis in the human body, leading to menstrual disorders, irregular cycles, and even amenorrhea.

After being diagnosed, Liu Le tried to analyze her inducement. As a native of Shandong, she has always grown up in a relatively high - pressure environment - taking the high school entrance examination, the college entrance examination, the postgraduate entrance examination, and the civil service examination. Even after getting a job, she has to work hard for promotion. Even one week after returning to work from maternity leave, she was notified of a transfer to a more demanding position. The price was over - exhausting her body. "You may not notice these pressures at that time, but in fact, they cause great damage to your body." She regrets being too harsh on herself in the past.

Later, she saw a sentence shared by other patients on the Internet: "It won't kill you, but it won't let you live well." This came true for Liu Le.

First, there was a significant decline in her physical strength. She couldn't climb mountains, couldn't pick up her child, and even lost the energy to go shopping, which she used to love.

Before, Liu Le could go shopping from 9 a.m. to 10 p.m. and then go to a karaoke bar all night without any problem. But after being diagnosed, when she went shopping with her colleagues, she only had the strength to sit there and completely lost the interest in trying on clothes. Even the necklace she had always worn around her neck, she started to feel "heavy on her neck." "Your neck can no longer bear this weight."

Next, her work performance started to decline rapidly.

As a civil servant, Liu Le's work has always been very busy. Before, she enjoyed it, but under the control of hormones, Liu Le always had the idea of "suddenly not wanting to work anymore." "Anyway, I'll just lie flat, and you can't fire me." She even had a big fight with her leader. Fortunately, her leader was a straightforward man and didn't fall out with her. He just asked her what was wrong and said she seemed to be in a bad mood.

Liu Le's relationship with her husband also started to get worse.

Going to work every day had already exhausted all of Liu Le's energy. When she got home, she had no interest in anything. Although her husband would come and ask her what was wrong, where she was uncomfortable, and why she was like this, Liu Le didn't have the energy to explain. Even their sex life couldn't go on.

Slowly, Liu Le started to become anxious. Most of the time, she didn't know what she was anxious about. "But sometimes I'm very excited, and sometimes I'm extremely down," and she felt like "going crazy every day."

Yuan Yuan also had great mood swings after being diagnosed.

She couldn't work properly anymore. She would leave a company after staying there for a few months. In less than a year, she sold insurance, did WeChat business, and tried other jobs, but she didn't have the heart to persevere.

She started to worry about her relationship with her boyfriend. Premature ovarian failure made Yuan Yuan feel that she was getting old quickly. She had nasolabial folds, freckles on her face, and there were signs of atrophy in her uterus and ovaries. The cessation of estrogen secretion also affected her sex life with her boyfriend. She started to worry that if things continued like this, what if her boyfriend had an affair?

Because she resisted taking Femoston, Yuan Yuan's hormone levels started to drop, and she also had emotional problems. She couldn't eat or sleep well and even needed sleeping pills to fall asleep.

In 2020, Yuan Yuan went to the district maternal and child health hospital again. The doctor was shocked when he heard that Yuan Yuan had been diagnosed with premature ovarian failure. This doctor in his forties took out a thick book in front of Yuan Yuan and started to study the symptoms of premature ovarian failure, saying that he was seeing such a young patient with premature ovarian failure for the first time.

Immediately afterwards, Yuan Yuan started to be reluctant to go out and communicate with people. In her heart, there was a sense of shame about premature ovarian failure. "Will others think that you got this disease because you did something wrong? Because normal girls don't get this kind of disease. Many people who have given birth smoothly think this is an incredible thing."

"You need to take care of yourself now, not have a baby."

This state lasted until 2021.

That year, Yuan Yuan joined a group for patients with premature ovarian failure and found that she was not alone.

The group was full of patients diagnosed with premature ovarian failure, those in their early 20s, those in their early 30s, and those in their 40s. Everyone in the group supported each other, sharing their diagnosis experiences and daily anti - aging tips.

Once, the group leader shared a sentence in the group that impressed Yuan Yuan deeply. "She said that we just got sick and can't have children, but our lives are not affected. You can do many things to fight against it." Yuan Yuan suddenly realized that she couldn't go on like this anymore. "I can't blame all the problems on my illness."

She started to exercise and actively seek medical treatment. During the medical treatment process, Yuan Yuan met many young patients, even younger than herself, born in 1994, 1995, 1996, and the youngest was still in high school. As a "senior," she would advise them to go to bed early, exercise, and not eat cold things.

She started to actively adjust her attitude towards premature ovarian failure. Before, every time she went to see a doctor, Yuan Yuan's purpose was to get married and have children. She even took many detours because of this - for example, going to beauty salons for ovarian maintenance.

But now, the premise for Yuan Yuan to do these things is to improve her own health.

Last year, Yuan Yuan got married. Before getting married, she had told her boyfriend about her diagnosis, and the two had discussed the issue of having children. Her boyfriend said that he "could accept whether there was a child or not." Even if they couldn't have a child, they could adopt one.