Definition

What is premature ovarian failure?

Premature ovarian failure — also known as primary ovarian insufficiency — is a loss of normal function of your ovaries before age 40. If your ovaries fail, they don’t produce normal amounts of the hormone estrogen or release eggs regularly. Infertility is a common result.

Premature ovarian failure is sometimes referred to as premature menopause, but the two conditions aren’t the same. Women with premature ovarian failure can have irregular or occasional periods for years and might even become pregnant. Women with premature menopause stop having periods and can’t become pregnant.

Restoring estrogen levels in women with premature ovarian failure helps prevent some complications, such as osteoporosis, that occur as a result of low estrogen.

How common is premature ovarian failure?

Premature ovarian failure is relatively rare, occurring in one in 1,000 women under the age of 30 and one in 100 women under the age of 40. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of premature ovarian failure?

The common symptoms of premature ovarian failure are:

  • Irregular or skipped periods (amenorrhea), which might be present for years or develop after a pregnancy or after stopping birth control pills
  • Difficulty conceiving
  • Hot flashes
  • Night sweats
  • Vaginal dryness
  • Irritability or difficulty concentrating
  • Decreased sexual desire

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you’ve missed your period for three months or more, see your doctor to help determine the cause. You can miss your period for a number of reasons — including pregnancy, stress, or a change in diet or exercise habits — but it’s best to get evaluated whenever your menstrual cycle changes.

Even if you don’t mind not having periods, it’s advisable to see your doctor to find out what’s causing the change. Low estrogen levels can lead to bone loss.

Causes

What causes premature ovarian failure?

Although the exact cause of premature ovarian failure may be unknown, a genetic factor or a problem with the body’s immune system may play a role in some women. In an immune system disorder, the body may attack its own tissues-in this case, the ovaries.

Premature ovarian failure may develop after a hysterectomy or other pelvic surgery or from radiation or chemotherapy treatment for cancer. In some of these cases, the condition may be temporary, with the ovaries starting to work again some years later.

Risk factors

What increases my risk for premature ovarian failure?

There are many risk factors for premature ovarian failure, such as:

  • 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.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is premature ovarian failure diagnosed?

If your periods become irregular or stop, your doctor will give you a physical exam and ask you questions about your general health and whether you have other symptoms of premature ovarian failure. You will also have a pregnancy test. And your blood will be tested for other possible causes of irregular periods.

To check for possible ovarian failure, your blood level of follicle-stimulating hormone (FSH) will be checked. FSH signals your body to release an egg every month. If the amount of FSH in your blood is higher than normal on more than one day, you may have premature ovarian failure. Another blood test also may be done to measure the amount of estradiol (or estrogen) in your blood. Very low estrogen with a high FSH is a sign of premature ovarian failure.

Some women find out they have premature ovarian failure when they see a doctor because they are having trouble getting pregnant.

How is premature ovarian failure treated?

Treatment for premature ovarian failure usually focuses on the problems that arise from estrogen deficiency. Your doctor might recommend:

  • Estrogen therapy. Estrogen therapy can help prevent osteoporosis and relieve hot flashes and other symptoms of estrogen deficiency. Your doctor typically prescribes estrogen with the hormone progesterone, especially if you still have your uterus. Adding progesterone protects the lining of your uterus (endometrium) from precancerous changes caused by taking estrogen alone.
  • The combination of hormones can cause vaginal bleeding again, but it won’t restore ovarian function. Depending on your health and preference, you might take hormone therapy until around age 50 or 51 — the average age of natural menopause.
  • In older women, long-term estrogen plus progestin therapy has been linked to an increased risk of heart and blood vessel (cardiovascular) disease and breast cancer. In young women with premature ovarian failure, however, the benefits of hormone therapy outweigh the potential risks.
  • Calcium and vitamin D supplements. Both are important for preventing osteoporosis, and you might not get enough in your diet or from exposure to sunlight. Your doctor might suggest bone density testing before starting supplements to get a baseline bone density measurement. For women ages 19 through 50, the Institute of Medicine recommends 1,000 milligrams (mg) of calcium a day through food or supplements, increasing to 1,200 mg a day for women age 51 and older.

Scientists don’t yet know the optimal daily dose of vitamin D. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. If your blood levels of vitamin D are low, your doctor might suggest higher doses.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage premature ovarian failure?

The following lifestyles and home remedies might help you cope with premature ovarian failure:

  • Learn about alternatives for having children. If you’d like to add to your family, talk to your doctor about options such as in vitro fertilization using donor eggs or adoption.
  • Talk with your doctor about the best contraception options. A small percentage of women with premature ovarian failure do spontaneously conceive. If you don’t want to become pregnant, consider using birth control.
  • Keep your bones strong. Eat a calcium-rich diet, do weight-bearing exercises such as walking and strength-training exercises for your upper body, and don’t smoke. Ask your doctor if you need calcium and vitamin D supplements.
  • Keep track of your menstrual cycle. If you miss a period while taking hormone therapy that causes you to have a monthly cycle, get a pregnancy test.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: December 4, 2017 | Last Modified: December 4, 2017

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