Many young women feel self-conscious about displaying their body on the beach, but Corinna Bordolli was worried about it for fear people might catch sight of the HRT patch stuck to her thigh.

Normally this is something you see on women in their 40s or 50s to manage symptoms of the menopause: Corinna wore a hormone replacement patch from around the age of 25 for a different condition.

Corinna, now 29, who lives in North London, suffers from premature menopause – or premature ovarian insufficiency (POI).

In essence, this means the ovaries intermittently stop working as normal – although for Corinna, because it started so early in her teens, it is thought they never worked at all (Corinna’s case is unusual in that she developed it so young).

Most common in women aged 35 to 40, the condition means women don’t produce enough oestrogen and other hormones made in the ovaries, such as progesterone and small amounts of testosterone.

The problem is that too often, women affected are diagnosed late, putting them at long-term risk of weakened bones and cognitive decline as a result of the lack of oestrogen.

‘The lack of hormones can cause a wide range of symptoms, including irregular menstrual cycles, hot flushes, night sweats, mood disturbances, palpitations, joint pain, vaginal dryness, low libido – as well as skin and hair changes,’ says Dr Kate Maclaran, a consultant gynaecologist at Chelsea and Westminster Hospital Foundation Trust in London.

POI can also lead to infertility – but whereas with the menopause which causes the ovaries to permanently stop working, POI means ‘ovarian activity may be intermittent and spontaneous pregnancies can still occur in some women’, says Sangeeta Khinder, a consultant obstetrician and gynaecologist at the private London Gynaecology clinic.

Around one in 100 women under 40 in the UK develop POI – ‘often without warning, with the first symptom a missed period for instance,’ adds Dr Khinder. ‘This can make the diagnosis feel both sudden and bewildering.’

Dr Maclaran, who is a trustee of the Daisy Network, a charity offering information and support for those with the condition, adds: ‘A diagnosis of POI has an enormous psychological impact on women.’

A lack of oestrogen can cause anxiety and depression and the diagnosis itself takes an emotional toll – ‘feelings of isolation, loss of femininity and premature ageing are common, as well as the potentially devastating effects of the loss of fertility,’ she explains.

Corinna and her doctors had no idea that symptoms she experienced from the age of ten – including heart palpitations, migraines, anxiety and such dry vocal cords that it hurt to sing – were all related to the condition.

It wasn’t until the age of 15 and with no signs of puberty – ‘I hadn’t developed breasts or started my period,’ recalls Corinna – that she was referred to a hormone specialist, who ran blood tests.

Corinna heard her mother sob when she got the call from the doctor to say her daughter’s ovaries were not working and she’d never be able to have children.

‘Mum was shaken and shed a few tears, but I didn’t really understand what was going on,’ she says.

But at that point Corinna and her mum were left in the dark about the cause.

‘I was confused, angry and upset that the doctors hadn’t explained what was going on – the consequences or the best treatment,’ says Corinna, who runs a childcare agency called CocoRio.

Her doctor said she’d be put on the Pill, which would cause her to have a ‘period’ – in reality, a withdrawal bleed which occurs due to dropping hormone levels after a break in birth control tablets, leading the body to shed the uterine lining.

The Pill helped with some symptoms, such as palpitations, but didn’t alleviate others such as her migraines – and by the age of 25, the list of symptoms Corinna was experiencing had grown to include erratic mood swings, low libido and acne.

She also struggled to digest gluten and dairy and noticed that she seemed to pick up injuries easily – once breaking a bone in her foot just by standing on her tiptoes.

It was while Googling her symptoms that Corinna stumbled across details about POI – and immediately recognised the signs.

Diagnosis is normally confirmed with a blood test to check for raised levels of follicle-stimulating hormone – which is released from the pituitary gland in the brain, and helps control ovarian function.

In women with POI the pituitary gland pumps out more FSH than normal, to try and stimulate the ovaries in the absence of oestrogen.

Detecting the condition as soon as possible is important as long-term oestrogen also has vital bone, heart and brain-protective properties.

Without treatment women with POI may otherwise be at risk of longer-term risks such as weakened bones, cardiovascular disease and cognitive decline.

Women are usually offered hormone replacement therapy (HRT) – typically taken as a combination of oestrogen and progesterone – until the natural menopause age to make up for their shortfall.

However, Dr Maclaran adds: ‘Many women suffer significant delays in diagnosis and have to see multiple health professionals before a diagnosis is made. We need better education to ensure women get timely treatment.’

After stumbling across information about POI online, Corinna contacted her specialist ‘who apparently knew I had POI already but had never told me – and agreed to switch me from the Pill to HRT’, she recalls.

‘However, again, they didn’t explain why I had only been offered the Pill to begin with. It would have been important for me to make an informed choice, knowing that HRT is the most similar alternative to natural hormones produced by healthy women.

‘I think perhaps doctors tend to give younger women quick and easy fixes – it’s easier to give a girl one pill a day that will make her slightly better than a complex regimen that needs adjusting.’

Corinna was also given vaginal oestrogen, oestrogen patches, progesterone pills and testosterone gel.

But she lost a lot of weight and her digestive problems got worse in her 20s – so she ended up consulting a private hormone specialist, Dr Louise Newson, who gradually moved her to a higher dose of HRT.

‘For the first time in my life I felt alive,’ says Corinna.

Although her physical and emotional health are vastly improved, she struggled when she was younger: ‘I was too ashamed to tell anyone that I wasn’t having periods and my breasts hadn’t grown – I am not entirely flat but they have not developed properly,’ she says.

‘I felt so self-conscious, particularly on the beach or going swimming during my teens and early-20s, where I was sure people would be able to see my HRT patch.

‘As my friends started getting interested in boys, I steered clear because I didn’t want to have to tell anyone what was wrong with me.’

Up to 70 per cent of POI cases – including Corinna’s – remain unexplained.

But thanks to recent breakthroughs, scientists now believe some cases may be partly autoimmune – where the immune system falsely attacks ovarian tissue, stopping it from working properly.

It’s known that women with the autoimmune conditions such as autoimmune thyroiditis (which causes an underactive thyroid gland) and Addison’s disease (affecting the adrenal glands) may also develop ovarian dysfunction.

Genetic and environmental factors may also play a role.

‘Chemotherapy, radiation therapy in the pelvic area and ovarian surgery can also cause it, as they may damage the ovaries,’ adds Dr Khinder. ‘In rare cases, viral infections and environmental toxins could also pose a threat to ovarian health.’

Lifestyle changes – including adequate calcium and vitamin D intake, maintaining a healthy weight, avoiding smoking and doing regular weight-bearing exercise – can help, but ‘there are new treatments on the horizon’, says Dr Khinder.

‘Early studies suggest stem cell therapies and platelet-rich plasma (PRP) injections may reactivate dormant follicles in the ovaries that release eggs and help restore some ovarian function – potentially offering future treatments for women facing hormone loss and infertility at an early age, adds Dr Khinder.

Such approaches are currently experimental and unlikely to benefit Corinna.

She now has yearly check-ups, her hormones are regularly monitored and she has DEXA scans regularly to check her bone density.

When Corinna began dating she was always honest with potential partners that she couldn’t have children – though struggled to explain the cause.

She now has private counselling, which she says is helping her to ‘accept my health and not feel ashamed’.

She adds: ‘I’ve had to rethink my idea of “what a woman is” – it’s not just about having children. If I do want children in the future, I would probably adopt or do egg donation IVF.’

Most of all she’d like other women in her position to realise they’re not alone: ‘You mustn’t feel ashamed as there are so many women going through a similar experience,’ she says.