07 Nov Premature Ovarian Failure: What Does it Mean?
Premature ovarian failure (POF), also called premature ovarian insufficiency (POI), is diagnosed when ovaries stop releasing eggs before the age of 40. A less common infertility diagnosis, it occurs in 1 out of 1000 women under the age of 30, and 1 in 100 women between the ages of 30 and 40. The average age of onset for premature ovarian failure is age 27.
While infertility is a direct effect of POI, it’s also important to note that women diagnosed with the condition are at higher risk for osteoporosis and heart disease, as well as depression and anxiety. Your general physician or healthcare provider should also be aware of your diagnosis so they can work with you to create a comprehensive, long-term health and wellness plan.
Causes and Risk Factors
Unfortunately, direct causes of POF are rarely known in 90% of the cases we diagnose. Certain circumstances, such as radiation or chemotherapy used to treat cancer or severe pelvic inflammatory disease can cause POF. Other known causes are chromosomal defects or autoimmune disorders that attack ovarian tissue. About 4% of POI cases seem to be hereditary.
Additional risk factors include:
- Being born with a lower number of follicles
- Exposure to certain toxins (read, Toxins Toll on Fertility)
- Metabolic defects (hypothyroidism is a cause of POI)
- Smoking (also considered a toxin, it deserves specific mention that women who smoke are more likely to be diagnosed with premature ovarian failure)
Symptoms of Premature Ovarian Failure
Symptoms of POI include:
- Irregular or absent periods
- Periods that seem to have stopped altogether
- Night sweats, hot flashes, atypical mood swings, vaginal dryness and other symptoms typical of menopause
Irregular periods are the first and most notable symptom that you are having some type of problem with ovulation. We can’t emphasize enough that irregular periods should never be ignored, and should always trigger a visit to your OB/GYN as soon as you can get in.
Testing and Diagnosis
Additional signs of premature ovarian failure are elevated FSH levels on Day 3 of your menstrual cycle, as well as elevated LH levels – and low estrogen. Low thyroid function is also detectable via diagnostic testing. These signs wouldn’t be noticed by you, which is why missed periods should trigger an immediate appointment with an OB, who will order necessary blood tests.
A fertility specialist suspecting POI will additionally use a transvaginal ultrasound to evaluate the ovaries visually. If premature ovarian failure is the diagnosis, the ovaries appear smaller than average, and fewer follicles are visible.
If you’re already trying to get pregnant and have struggled to conceive, it’s wise to consult with a fertility specialist because the combination of missed periods and infertility means more specialized treatments may be needed.
Treatment is Possible – Time is of the Essence
Depending on when POF is diagnosed, it may be treatable, but it depends on the testing results – and how functional the ovaries/follicles remain.
For example, estrogen therapy can be helpful if low estrogen was detected, and administration of high dose human menopausal gonadotropins after using estrogen/progesterone replacement therapy has resulted in pregnancy in a small number of cases. Thyroid medication may be prescribed for low thyroid function, and some autoimmune disorders can be repressed using steroids.
In most cases, fertility specialists recommend IVF treatment for the highest chances of pregnancy success because time is of the essence. If your own eggs are no longer available, you can still get pregnant via an egg donor combined with IVF.
Get in touch with us here at the Fertility Center of Dallas if you’re experiencing symptoms of premature ovarian failure, or if you’ve received a diagnosis from your OB and are interested in moving forward with fertility treatments.