Having not had a period for three months and after gaining a little weight around her middle, Julia Champion convinced herself that, at 53, she must be menopausal.
‘I wasn’t particularly happy about my bloated belly but decided I’d cut back on calories and do more exercise when I had time,’ says Julia, now 55, a publicist from Sydenham, South-East London.
But then during a three-hour drive to Suffolk during the summer of 2022, Julia had to stop five times to go to the loo.
‘On a few occasions, I didn’t even make it to the service station and had to stop the car and run into the bushes,’ she says.
‘My sister Jenny and niece Carrie were with me and said that they had noticed that I was weeing more than normal lately. Carrie said it could be a sign of diabetes and that I should get checked at the GP.’
Julia Champion was lost for words when her GP told her she was expecting at the age of 53
Julia made an appointment for the following week and within 24 hours of giving a urine and blood sample, she got a call from the surgery.
‘They said my results had arrived and could I come to the surgery to discuss them as soon as possible, which immediately made me worry that it was something serious,’ says Julia, who is married to Matt, 54, a businessman, and has two teenage daughters.
Julia was utterly unprepared for what her GP told her. ‘She said, “The good news is you’re not diabetic and it’s not a thyroid problem – but you are pregnant”,’ recalls Julia.
‘I was stunned. For a few seconds I couldn’t say anything. Then I said, “I can’t be pregnant, I’m 53!”
‘The GP nodded and said,“It’s not as unusual as you think”.’
In fact, more than five women aged 50 and over gave birth every week between 2018 and 2021, according to the Office for National Statistics.
‘Matt and I had not been using contraception because I thought I couldn’t get pregnant any more,’ says Julia. ‘I was shocked but if I’m completely honest, I was a little bit excited as well.
‘My daughters, Rosie and Bella, are now 18 and 15 and although Matt and I had agreed not to have another child, I’d always wanted more.’
Julia went straight back home and broke the news to Matt. ‘He was so shocked and very worried that we couldn’t afford a third child,’ she says. As Julia hadn’t had a period in months, her doctor sent her for an ultrasound to check how advanced the pregnancy was, and this brought more surprises.
After running the probe over Julia’s stomach, the sonographer said she was just getting an obstetrician to pop in.
‘Then they said, “Can you hop off the bed and do another pregnancy test?”’ says Julia.
‘They gave me a stick to wee on and a few minutes later it came back negative.
She had a positive test but further examination revealed the true issue
‘I was told that I wasn’t pregnant but had a large cyst on my ovaries, which was putting pressure on my bladder – which explained why I was weeing so much and had put weight on.’
Rather than prepare for a baby, Julia had to prepare for surgery the next week to remove the cyst.
‘I have to admit that part of me was disappointed that I wasn’t going to have another baby, and I was a bit upset.’
Ovarian cysts (also called tumours) are surprisingly common – according to the Royal College of Obstetricians and Gynaecologists, around 10 per cent of women will need surgery at some point to remove one – and they can cause positive pregnancy tests (another cause of false positive pregnancy tests is the menopause, but more on that later).
That’s because certain ovarian tumours including benign teratomas, as Julia had, which form from cells within the eggs of the ovary, may release human chorionic gonadotropin (hCG) – ‘which is the hormone that can give a positive pregnancy test’, explains Dr Sangeeta Khinder, a consultant obstetrician and gynaecologist at the private London Gynaecology clinic and Whittington Health NHS Trust.
This hormone is usually released by cells from the placenta in pregnancy, but levels may also rise in women with ovarian cysts, or who are taking medications including certain antidepressants and – perhaps less surprisingly – fertility drugs, adds Dr Khinder. This can cause confusion as the resulting rise in hCG can stop periods, as the hormone encourages the womb lining to thicken to prepare for a baby and signals to the body to stop the lining being shed as it is for periods.
‘I’ve had young women who miss a period, then have an ultrasound for pregnancy and it shows an ovarian tumour instead,’ says Dr Khinder.
‘Around 8 per cent of menopausal women can also have a positive pregnancy test, either in the presence of a cyst or even randomly.
‘This is because when you go through the menopause, oestrogen and progesterone levels fall and this has a negative feedback on the pituitary gland, which in return releases hCG at a small level – but it’s enough to give a false positive pregnancy test.’
Dr Khinder adds: ‘We do see women in their 50s get pregnant and usually it’s IVF or occasionally spontaneous, but it’s not what I’d call common.’
Typical symptoms of an ovarian cyst are bloating, pelvic pain, swollen tummy, urinary symptoms such as frequency and incomplete emptying, change in periods and pain during sex.
Sometimes they can grow up to 12cm and press on the bladder, which can give you a feeling of being full and make you look pregnant.
Now 55, Julia thought the lack of periods two years ago was part of the menopause
Dr Khinder advises that women with such symptoms ask for an ultrasound. ‘If left, these cysts can grow and the worry is that they will twist and cause acute pain or cause the ovaries to die because of the decreased blood supply.’
In premenopausal women the risk of these cysts being cancerous is one in 1,000; it’s three in 1,000 for women over 50.
‘Leaving them to grow doesn’t increase the risk of it becoming cancerous – but we usually advise removing cysts if they are large or causing symptoms,’ adds Dr Khinder.
Julia had surgery three days after her ultrasound to remove the cyst, which was found to be non-cancerous. A biopsy taken during the surgery also ruled out endometrial cancer, forms of which can also cause a rise in hCG levels.
Although her operation ended her urgency to go to the loo and bloating, Julia suffered with heavy bleeding afterwards.
‘The following week I had the heaviest period of my life,’ she says. ‘I called to see a friend and she had to give me some incontinence pads because I couldn’t stop bleeding.’
Dr Khinder says such bleeding can happen after a cyst removal.
‘The hormone hCG stops your periods, so when the cyst creating the hCG is removed, it’s likely you will have heavy bleeding if you’re pre-menopausal,’ she says.
Julia was advised to have a Mirena coil, which releases the hormone progesterone inside the womb to help thin the lining, reducing bleeding.
‘It was agony to put in, but since then I have been fine.’
She has been warned there is a 4 per cent risk of the cyst recurring but this time Julia knows what to watch for.
She says: ‘I was sad that I wasn’t about to be a mother again, but I know it’s probably for the best.’
[Notigroup Newsroom in collaboration with other media outlets, with information from the following sources]
