Premature Ovarian Insufficiency (POI): A Physician's Journey Through Cancer, Hormones, and Healing with Dr. Esra Shermadou

In this powerful episode of the Love and Science Podcast, Dr. Erica Bove sits down with Dr. Esra Shermadou, a board-certified family medicine physician, to explore premature ovarian insufficiency (POI) through both a medical and deeply personal lens.

Diagnosed with cancer at just 21 years old, Dr. Shermadou shares how chemotherapy and a stem cell transplant led to POI, shaping her understanding of hormone health, fertility, and long-term wellbeing. Together, Erica and Esra unpack why POI is often misunderstood, how outdated hormone narratives have left many women under-treated, and what women truly need to protect their overall health.

This conversation goes beyond fertility and speaks to the emotional, physical, and identity-shaping impact of a POI diagnosis.

In this episode, you’ll learn about:

• What premature ovarian insufficiency really is

• POI after chemotherapy and cancer treatment

• Hormone therapy myths and what women actually need

• Long-term health risks of untreated POI

• Strength training, lifestyle medicine, and longevity

• Reclaiming agency and confidence after diagnosis

If you or someone you love has been diagnosed with POI or feels confused about hormone care, this episode offers clarity, validation, and hope.

Guest Details: Dr. Esra Shermadou
Dr. Esra Shermadou is a board-certified family medicine physician and a diplomate of the American Board of Obesity Medicine. After navigating her own journey with premature ovarian insufficiency, she became deeply passionate about women’s health, hormone therapy, and sustainable lifestyle change.

She is the founder of Sakinah Health, a direct primary care clinic in Dayton, Ohio (opening mid-November 2025), offering personalized, root-cause care to help women and men feel like themselves again.

Connect with Dr. Esra Shermadou

Website: https://SakinahHealth.com

Instagram: @dresra_shermadou_do and @dresrasgottheiron

As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice.

If you found this conversation valuable, book a consult call with me using this link:

https://calendly.com/loveandsciencefertility/discovery-call

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Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always.

In Gratitude,

Dr. Erica Bove

Transcript:

Hello, my loves, and welcome back to the Love and Science Podcast.

I am so excited for today’s episode. I have a dear friend and colleague joining me. Her name is Dr. Esra Shermadou, and she is an incredible human. We are going to have such a meaningful and beautiful conversation today.

By way of introduction, Dr. Shermadou is a board-certified family medicine physician and a diplomate of the American Board of Obesity Medicine. After navigating her own journey with premature ovarian insufficiency, she became deeply passionate about women’s health, hormone therapy, and sustainable lifestyle change. Her lived experience profoundly shapes her patient care, especially her commitment to helping others take back control of their health — which is exactly what we do here at Love and Science.

She is also the founder of Sikina Health, a direct primary care clinic in Dayton, Ohio, designed to help both women and men feel like themselves again. We will absolutely dive into that as well.

Dr. Esra, thank you so much for being here today.

Thank you so much for having me. I’m really excited to be here.

Absolutely. And I want to start by saying that I’ve actually never explicitly talked about primary ovarian insufficiency on the podcast before. We’ve talked about diminished ovarian reserve, we’ve talked about a lot of fertility-related topics, but we’ve never gone deep into POI.

Can you share your personal journey with us — how you received your diagnosis, what that process looked like, and how you navigated it?

Premature ovarian insufficiency is defined as the loss of ovarian function before the age of 40. There are many different causes. In my case, it was due to chemotherapy, but it can also be autoimmune, medication-related, or from other medical conditions.

I was diagnosed with cancer when I was 21 years old. I had lymphoma. I honestly woke up one morning with a significant amount of swelling in my neck, and from there everything moved very quickly.

I went through an extensive course of chemotherapy that ultimately ended with a stem cell transplant. Because of the intensity of the chemotherapy, there was always a known risk of losing ovarian function — and unfortunately, that is what happened.

At the time of my diagnosis, there was a brief discussion about options to try to protect my ovaries. But looking back, it was a very quick conversation. I think part of that was simply where medicine was at during that time.

After treatment, I was focused on survival, recovery, and getting back to school. A lot of what followed was learning on my own and supporting myself through the diagnosis. It has truly been quite a journey.

If you don’t mind me asking, how old are you now?

I’m 36.

And you were diagnosed at 21, while you were still in college?

Yes. I went through about a year of treatment and finished when I was around 22. After treatment, we were told that it might take some time for ovarian function to return.

During cancer treatment, I was placed on birth control pills in an attempt to possibly preserve ovarian function. After treatment ended, I stopped the pills.

About eight months later, I asked my oncologist whether my cycles should have returned by that point. She referred me to a reproductive endocrinologist, who ran testing — AMH and other hormone levels — and everything was extremely low and suppressed.

We tried supplements to see if ovarian function could be stimulated, but it did not work. At that point, I was told that I needed to be on birth control pills until around age 51, and that was essentially the end of the conversation.

Around the same time, I was just starting medical school, which was about two and a half hours away. As anyone in medical training knows, there is very little time to take care of yourself.

I would run out of birth control prescriptions, and when I went home on weekends, there often wasn’t enough time to see a doctor. So I would be off hormones for months, sometimes years.

At the time, I didn’t understand the importance of hormone replacement. I was simply told I needed to be on birth control pills. Then in medical school, we learned about the WHI study and how hormones were portrayed as harmful, and I thought, why would I want to be on these?

I wasn’t motivated to take them.

I didn’t have severe hot flashes initially. Looking back, sleep issues and anxiety were probably the biggest symptoms — though it’s hard to separate that from the stress of medical training.

I never felt properly educated. When I tried to research on my own, I kept finding outdated guidelines and wasn’t sure if what I was reading was accurate.

At one point, during my intern year, I tried estradiol and Prometrium. But I went from supratherapeutic hormone levels on birth control to much lower physiologic doses — and that transition was incredibly difficult. I experienced hot flashes, mood changes, and felt terrible.

I stopped hormones altogether and stayed off them for quite some time.

It wasn’t until 2023 that I came across a course specifically addressing POI. There was very little information available, especially regarding POI secondary to chemotherapy. That course opened my eyes and ultimately led me toward my passion for women’s hormone health and education.

It was an unexpected outcome of my journey, but one I’m very grateful for.

Thank you for sharing that. I think your story highlights such an important gap in medicine.

Even as a reproductive endocrinology fellow, I didn’t truly understand POI until I was actively caring for patients with it. And when I searched the literature, I realized how many unanswered questions there still are.

So much data was extrapolated from the WHI study — applying results from older, unhealthy populations to young women with POI — and that simply doesn’t make sense.

You truly embody the idea of the wounded healer. This wasn’t part of your plan, but it shaped you into the physician you are today.

How has this diagnosis shaped you — both as a woman and as a physician?

At the time of diagnosis, my focus was survival and finishing school. I was on a mission. I don’t think I allowed myself time to process what was happening emotionally.

Medical training reinforced that mindset. You suppress emotions, push through, and keep going.

Only in recent years have I allowed myself space to reflect and process.

This experience taught me that women have different values, goals, and timelines. Some want children, some don’t — and all of those paths deserve respect and support.

But education is critical. When women understand their options, it allows them to make informed decisions — not just in the moment, but over the course of their lives as their values evolve.

Before your diagnosis, did you envision having a family?

I think I expected it, but it wasn’t something I deeply planned around. I come from a large family and love it, but I never had a specific vision of how many children or what that would look like.

At that stage of life, I was so focused on school and getting through treatment that fertility wasn’t something I spent a lot of time thinking about.

As you moved forward into residency and adulthood, was there grief to process?

I think my diagnosis made me very goal-oriented and emotionally guarded. I told myself motherhood wasn’t in the picture and moved forward focusing on career and life goals.

I don’t think I fully allowed myself to process emotions at the time. That’s something I’m still reflecting on.

That resonates deeply. So much of life exists in the messy middle, and it takes time to peel back those layers.

If you could rewrite that early experience, is there anything you wish had been different?

I wish there had been more education and more time. The conversation felt rushed, though I understand why.

Medicine was in a different place then. Fertility preservation wasn’t commonly discussed, and egg freezing felt extreme and inaccessible.

I don’t blame my oncology team. I had incredible care. I think this reflects where medicine was at the time.

That perspective is so generous — and so important.

As medicine continues to evolve, we’re learning that ovarian function isn’t all-or-nothing. There are still possibilities, even years later.

As someone living with POI, what support do you wish existed?

I believe support must be multifaceted.

Medical support for appropriate hormone therapy, fertility counseling, bone, heart, and brain health.

Lifestyle support — nutrition, strength training, sleep, stress management.

Emotional support — community, counseling, connection with others who understand.

And financial guidance — helping navigate treatment options and costs.

In an ideal world, there would be comprehensive POI centers offering ongoing, integrated care.

That vision is powerful.

Your work also beautifully integrates hormone health with strength training. Can you share why that combination is so important to you?

Strength training became part of my life during cancer recovery. It transformed my physical and mental health.

Beyond bone density and metabolic health, it offers stress relief, confidence, and emotional resilience.

Even two 30-minute sessions a week can make a profound difference.

It doesn’t need to be complicated — starting with bodyweight exercises, home workouts, or short “exercise snacks” throughout the day can be incredibly effective.

It’s about consistency, creativity, and prioritizing long-term health.

For someone who struggles to enjoy strength training, what would you say?

Motivation isn’t always present — and that’s okay. We do many things in life because they serve our future selves.

Start small. Build habits. Find accountability. Explore different formats until something clicks.

It takes time, but the benefits are life-changing.

Is there anything else you’d like to share with our listeners?

We all go through hardship. And while those experiences are painful, they shape us in ways that allow us to help others.

Even the hardest journeys carry growth, purpose, and meaning.

My hope is that my story inspires others to care for themselves, advocate for their health, and believe in their strength.

Thank you so much for sharing your story and your wisdom.

Where can our listeners find you?

You can find me on Instagram, TikTok, YouTube, and Facebook under Dr. Esra Shermadou.

I’ve also recently started a new Instagram page called Dr. Esra’s Got the Iron, where I focus on strength training, home workouts, and helping people at every stage get started.

I love your content — it’s powerful, grounded, and inspiring.

To our listeners, go follow her. Especially if you are navigating POI, hormone health, or strength training — her message will resonate deeply.

Thank you again for being here.

Thank you so much for having me.

And to my loves — I love you. Until next time. Bye.