Premature ovarian failure

What is premature ovarian failure?

Premature ovarian failure (POF), also known as primary ovarian insufficiency, is a disorder characterized by loss of normal ovarian function before the age of 40. This results in infertility, irregular or missed periods, and menopausal symptoms like hot flashes and vaginal dryness.

Some key points about POF:

• It impacts 1% of women under age 40 and 0.1% under age 30


• The cause is often unknown but can involve genetics, autoimmune disorders, chemotherapy treatment, or injuries


• Women with POF typically have low estrogen levels but may still ovulate occasionally


• POF is usually permanent but pregnancy is sometimes possible, especially within the first few years of diagnosis

Diagnosing POF involves blood tests for hormones like FSH and AMH as well as imaging and genetics testing. Treatment focuses on managing symptoms and often involves hormone replacement therapy.

"I was devastated when diagnosed with POF at age 28. My doctor prescribed bioidentical hormones from Vital Hormone Clinic to help me through menopause. Now I feel like myself again thanks to their personalized care."

While coping with POF can be extremely difficult, support groups and finding the right medical team can help. Research on experimental treatments like ovarian tissue freezing provides some hope that ovarian function may be preserved or restored in the future.

Signs and Symptoms

Common signs of POF include:

• Irregular or missed periods


• Hot flashes


• Vaginal dryness


• Difficulty conceiving

Around 5-10% of women with POF can still conceive naturally despite their diagnosis. However, fertility decreases over time.

Causes

Known causes of premature ovarian failure include:

• Genetic factors - chromosomal abnormalities and gene mutations that affect ovarian function


• Autoimmune disease - when the body attacks ovarian tissue


• Cancer treatment with radiation or chemotherapy


• Injuries from surgery or to the ovaries themselves

In many cases, the underlying trigger remains unknown.

Diagnosis

To diagnose POF, doctors measure hormone levels with blood tests. Key markers include:

• Follicle stimulating hormone (FSH) - FSH is released by the pituitary gland to stimulate ovulation. High FSH generally indicates poor ovarian function


• Anti-mullerian hormone (AMH) - AMH is produced by follicles in the ovaries. Low levels are associated with reduced fertility

These tests may be repeated over several cycles to confirm ovarian decline. Pelvic ultrasounds and other imaging tests can check for anatomical problems. Genetic testing also helps determine causes.

Treatment

While there is no cure for POF, various treatments can help manage symptoms:

• Hormone replacement therapy (HRT) with estrogen and progesterone relieves hot flashes and vaginal atrophy


• Modifying risk factors like smoking, alcohol use, and maintaining a healthy BMI


• Fertility preservation - techniques like egg freezing may preserve chances of conception


• Support groups and counseling for the depression and emotional distress of early menopause

Researchers continue investigating future options like stem cell and ovarian tissue transplant to restore ovarian function.

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