What is premature ovarian failure?
Premature ovarian failure (POF), also known as primary ovarian insufficiency, is a condition characterized by loss of normal function of the ovaries before age 40. The ovaries stop producing normal levels of the hormone estrogen, which causes symptoms like irregular periods, infertility, and menopause-like effects.
Some key points about POF:
- It affects about 1% of women under age 40, or 1 in 100 women
- The cause is often unknown, but can include genetics, autoimmune disorders, and cancer treatment side effects
- Diagnosis is made by blood tests for hormone levels including follicle-stimulating hormone (FSH)
- Treatment focuses on managing symptoms and usually involves hormone replacement therapy
Causes
- Genetic conditions like Turner syndrome and Fragile X syndrome
- Autoimmune disorders
- Cancer treatments like chemotherapy and radiation therapy
- Infections
- Toxic damage to ovaries
Some women develop POF for unknown reasons. There is ongoing research about contributing genetic and environmental factors.
Diagnosis
POF diagnosis involves blood tests measuring levels of key hormones:
- Follicle-stimulating hormone (FSH) - FSH levels are elevated when ovarian function declines
- Anti-Mullerian hormone (AMH) - AMH levels show remaining egg supply
- Estradiol - Low levels confirm lack of estrogen
- Other relevant hormones
Pelvic exams, genetic tests, or ovarian biopsy may be performed seeking an underlying cause.
Treatment
Treatment cannot restore lost ovarian function, but focuses on managing POF symptoms and health risks, including:
- Hormone replacement therapy (HRT) with estrogen/progestin to relieve menopause-like effects
- Fertility assistance may be possible, like using donor eggs for IVF
- Bone density monitoring and medication to prevent osteoporosis
- Counseling and lifestyle changes regarding sexual health, mental health, nutrition, exercise, etc.