Premature Ovarian Failure

Premature ovarian failure occurs when a woman’s ovaries stop functioning normally before age 40. Also known as primary ovarian insufficiency, the condition occurs in only about 1 percent of women, but can occur as early as the teenage years.


Understanding premature ovarian failure

Premature ovarian failure affects the function of the ovaries causing both menstruation and estrogen production to cease. In some women, POF is intermittent, leading some experts to instead refer to the condition as premature ovarian insufficiency.


Symptoms of premature ovarian failure

Symptoms of premature ovarian failure are often due to low estrogen levels and are similar to those of menopause. Hot flashes, vaginal dryness, night sweats and irritability are all symptoms of POF.

Some women with premature ovarian failure never menstruate at all. However, others with the condition may continue to experience intermittent periods if the ovaries function occasionally. This is one way the condition differs from normal menopause.


Causes of premature ovarian failure

The cause of premature ovarian failure is largely unknown, but for some women the condition can result from an underlying autoimmune or genetic condition or previous insult to the ovaries from chemotherapy or radiation.


Diagnosing premature ovarian failure

Reproductive endocrinologists usually diagnose premature ovarian failure through hormone testing. Blood tests may be done to look for significantly elevated FSH or with associated low estradiol levels. Chromosomal analysis and Fragile X syndrome mutation tests may be done if a genetic cause is suspected. The physician will typically also screen for autoimmune conditions like thyroid disease or diabetes since some women with POF can be at increased risk of these other conditions.

Since women with premature ovarian failure are at a higher risk for osteoporosis, your fertility specialist or gynecologist may also recommend bone density testing and, if necessary, hormone replacement therapy.


Fertility treatment in premature ovarian failure

Treatment of premature ovarian failure includes estrogen therapy to reduce menopausal-like symptoms. Calcium and vitamin D supplements are also recommended to help prevent osteoporosis.

In time, some ovarian function may temporarily return in women who have received chemotherapy or radiation, but premature ovarian failure is ultimately irreversible. Women with the condition should discuss fertility treatment options, such as IVF with donor eggs, with a reproductive endocrinologist.

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