Premature Ovarian Failure (POF)
Premature ovarian failure (POF), also known as primary ovarian insufficiency, is a condition where the ovaries stop functioning normally before age 40. This results in irregular periods or missed periods (amenorrhea) and reduced fertility.
Some key points about POF:
- It affects roughly 1% of women under age 40.
- The cause is often unknown, but can include autoimmune disorders, genetics, chemotherapy treatment, or infections.
- Main symptoms are irregular/missed menstrual cycles and difficulty getting pregnant. Other symptoms may include hot flashes, mood changes, vaginal dryness.
- Diagnosis is usually made with blood tests showing high FSH levels.
- Treatment focuses on managing symptoms and emotional health. Hormone therapy may help. Infertility treatments may be attempted but success rates are low.
What causes premature ovarian failure?
There are a few known causes, though in many cases no specific cause is found:
- Autoimmune disorders - The body's immune system mistakenly attacks the ovaries.
- Genetic factors - Chromosomal abnormalities or genetic mutations can lead to ovulation issues.
- Cancer treatment - Chemotherapy and radiation therapy can damage ovarian function.
- Infections - Viral infections like mumps may trigger ovarian inflammation.
What are the symptoms of POF?
The hallmark POF symptoms are:
- Menstrual irregularities - Lighter, sporadic periods or complete cessation of periods (amenorrhea).
- Infertility and trouble conceiving - Due to lack of ovulation and egg production.
- Menopausal signs - Hot flashes, night sweats, vaginal dryness, decreased sex drive. These result from the drop in estrogen.
Other possible emotional symptoms are anxiety, depression, mood swings related to hormonal shifts.
How is POF diagnosed and managed?
- Blood tests for follicle stimulating hormone (FSH) levels over 40 mIU/mL on two tests can confirm ovarian failure and menopause. Anti-Müllerian hormone levels may also be tested.
- Genetic testing can sometimes detect related chromosomal issues.
- Managing symptoms - Hormone replacement therapy can provide estrogen/progesterone to help hot flashes, bone loss, etc. Birth control pills may regulate bleeding. Infertility treatments have low success rates but can be attempted.
- Emotional support - Counseling to help cope with the life impacts of early menopause and fertility challenges. Support groups can also help.
While upsetting, POF diagnosis does not mean a woman can never get pregnant. Spontaneous and unexpected conception can occasionally happen. But the odds of natural conception are less than 10% so women should be prepared for infertility. Coping with the range of impacts can be very difficult emotionally. Reaching out for support is important.
For more information, please visit the Harmonize Health.