What is premature ovarian failure?

Last week you enlightened us about endometriosis. I will like to on behalf of many helpless women commend you on your tireless efforts in educating us about our health. Please as a follow up to last week column, share with us information about premature ovarian failure. –  Esther V. Thanks Esther for your question. Premature […]

Last week you enlightened us about endometriosis. I will like to on behalf of many helpless women commend you on your tireless efforts in educating us about our health. Please as a follow up to last week column, share with us information about premature ovarian failure. –  Esther V.

Thanks Esther for your question. Premature ovarian failure also known as primary ovarian insufficiency is a loss of normal function of ovaries before age 40. If ovaries fail, they don’t produce normal amounts of the hormone estrogen or release eggs regularly.  Women then stop having periods and can’t become pregnant.

Symptoms  to check for?

Signs and symptoms of premature ovarian failure are similar to those of going through menopause and are typical of estrogen deficiency.

1.Irregular or skipped periods (amenorrhea), which might be present for years or develop after a pregnancy or after stopping birth control pills.

2.Difficulty conceiving.

3.Hot flashes.

4.Night sweats.

5.Vaginal dryness.

6.Irritability or difficulty concentrating.

7.Decreased sexual desire.

When to see a doctor?

If a lady misses her period for three months or more, she should see a doctor to help determine the cause. 

Likely causes:

In women with normal ovarian function, the pituitary gland releases certain hormones during the menstrual cycle, which causes a small number of egg-containing follicles in the ovaries to begin maturing. Usually one or two follicles, tiny sacs filled with fluid, reach maturity each month.When the follicle matures, it opens, releasing an egg. The egg enters the fallopian tube where a sperm cell might fertilize it, resulting in pregnancy.

Premature ovarian failure results from the loss of eggs (oocytes). This might be due to:

•Chromosomal defects. Certain genetic disorders are associated with premature ovarian failure. These include mosaic Turner’s syndrome in which a woman has only one normal X chromosome and an altered second X chromosome and fragile X syndrome in which the X chromosomes are fragile and break.

•Toxins. Chemotherapy and radiation therapy are the most common causes of toxin-induced ovarian failure. 

•An immune system response to ovarian tissue (autoimmune disease). In this rare form, immune system produces antibodies against ovarian tissue, harming the egg-containing follicles and damaging the egg. 

•Unknown factors. It is possible to develop premature ovarian failure, but have no known chromosomal defects, toxin exposure or autoimmune disease. 

Risk factors?

Factors that increase risk of developing premature ovarian failure include:

•Age. Risk rises between the ages of 35 and 40, although younger women and adolescents can develop the condition.

•Family history. Having a family history of premature ovarian failure increases your risk of developing this disorder.

•Multiple ovarian surgeries. Ovarian endometriosis or other conditions requiring repeated surgeries on the ovaries increases the risk of premature ovarian failure.

Complications?

Complications of premature ovarian failure include:

•Infertility. Inability to get pregnant may be the most troubling complication of premature ovarian failure, although in rare cases, pregnancy is possible until the eggs are depleted.

•Osteoporosis. The hormone estrogen helps maintain strong bones. Women with low levels of estrogen have an increased risk of developing weak and brittle bones (osteoporosis), which are more likely to break than healthy bones.

•Depression or anxiety. The risk of infertility and other complications arising from low estrogen levels causes some women to become depressed or anxious.

•Heart disease. Early loss of estrogen might increase your risk.

•Dementia. Lack of estrogen can contribute to this in some people.

Diagnosis usually involves a physical exam, including a pelvic exam. 

Some recommended tests

•Pregnancy test. This checks for an unexpected pregnancy in a woman of childbearing age who has missed a period.

•Follicle-stimulating hormone (FSH) test. FSH is a hormone released by the pituitary gland that stimulates the growth of follicles in your ovaries. Women with premature ovarian failure often have abnormally high levels of FSH in the blood.

•Estradiol test. The blood level of estradiol, a type of estrogen that comes from the ovaries, is usually low in women with premature ovarian failure.

•Prolactin test. High blood levels of prolactin, that stimulates breast milk production can lead to problems with ovulation, including irregular or absent menstrual periods.

Treatment for premature ovarian failure usually focuses on the problems that arise from estrogen deficiency. Some of the therapies that could be recommended are: 

•Estrogen therapy. Estrogen therapy can help prevent osteoporosis and relieve hot flashes and other symptoms of estrogen deficiency. 

•Calcium and vitamin D supplements. Both are important for preventing osteoporosis.