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Premature Ovarian Failure - Causes, Symptoms

and Treatment

Last Updated on December 30, 2020

Fertility problems can come as a heartbreaking hurdle in the family-

planning journey of a couple trying to conceive. Premature ovarian
failure, which affects about 1% to 4% of the population in the US alone,
is one of the fertility problems that women face, which prevents
conception.

What is Premature Ovarian Failure (POF)?

Ovaries are responsible for releasing an egg and the hormones

necessary to begin and continue a successful pregnancy. However, in
the case of Premature Ovarian Failure, also known as Premature
Ovarian Insufficiency (POI), the ovaries stop releasing eggs before you
hit the age of 40. The average onset age of this condition is 27 years,
but it may happen to women as early as in their teens. On certain
occasions, the condition is present right from birth. The risk of POF
increases with age.

Causes of Primary Ovarian Insufficiency

Premature ovarian failure is often due to the loss of eggs, which may
be a result of the following conditions:

Defects in the chromosomes: Genetic condition like Turner’s

Syndrome and Fragile X Syndrome are associated with POI. In
women with Turner’s Syndrome, there is one normal X
chromosome, but the second X chromosome is altered or missing.
On the other hand, the X chromosomes in women with fragile X
chromosomes syndrome are very weak and tend to break.
Toxins: Most women who undergo radiation and chemotherapy may
suffer from toxin-induced ovarian failure, as they can affect the
genetic make and material that are present in cells. Cigarettes,
drugs, pesticides, viruses, and chemicals may also speed up early
ovarian failure. Mumps virus is known to damage the ovaries and
cause failure.
Autoimmune diseases: Autoimmune diseases are when the
immune system in the body begins attacking the cells and tissues
native to the body. When an autoimmune disease affects the
ovaries, the antibodies damage the follicles in the ovaries that
contain eggs.
Idiopathic causes: Sometimes the cause for POI is unknown and
may not be identified, even on further testing.
Signs and Symptoms of Premature Ovarian
Failure

Symptoms of Premature Ovarian Failure are quite like the symptoms of

menopause and include:

Irregular periods
Night Sweats
Hot flushes
Trouble sleeping
Depression, irritability or anxiety
Trouble concentrating
Vaginal dryness
Reduced sexual desire

Diagnosis and Tests

Diagnosis of POI is usually done through the following tests:

Physical exam and medical history will be asked for. The doctor will
also inquire about your symptoms to locate the reason. You may
also be given a pregnancy test to rule out pregnancy.
Blood tests will determine the hormone levels in your body and
ensure whether your ovaries are functioning properly by checking
the level of follicle-stimulating hormone (FSH). FSH is the most
important factor in POF.
The levels of reproductive hormones like estrogen and luteinising
hormone (LH) are also determined.
Additional tests to check for autoimmune diseases and genetic
disorders are conducted.
Complications of Premature Ovarian Failure

Premature ovarian failure gives rise to certain complications like:

Infertility: If the eggs are completely depleted you have no chance

of getting pregnant. However, in case your eggs aren’t completely
depleted, you may still be able to conceive.
Osteoporosis: Estrogen hormone help maintain the strength of the
bones. Lower production of estrogen may result in weak and brittle
bones, which are prone to breaking.
Depression and anxiety: As women face the risk of infertility and
certain other complications due to the condition, they may go
through depression and anxiety.
Heart disease: Lack of estrogen or loss of estrogen at an early age
may increase the risk of heart disease.
Dementia: Lack of estrogen can also lead to or increase the risk of
dementia in many women.

Premature Ovarian Failure Treatment

While there is no treatment to return functionality to your ovaries, there

are a few options for treatment that may lower the symptoms of the
condition.

Hormone therapy is prescribed to women to add estrogen and

progesterone hormones into the body. This can be done through
pills, sprays, patches, gels or vaginal rings. Hormone therapy can
provide hormone balance to your body and reduce your risk of
conditions that may result as a result of lack of estrogen, like
osteoporosis, heart disease, dementia, etc.
Medicines may be prescribed to prevent hot flashes.
 Women may also opt for artificial insemination methods like in-vitro
fertilization (IVF) or get donor eggs to achieve pregnancy.

How to Prevent Premature Ovarian Failure

Although there is no definitive way to prevent Premature Ovarian

Failure, you can reduce the risk of complications like heart disease,
osteoporosis, etc, by maintaining a healthy lifestyle. A good, balanced
diet and regular exercise can be beneficial to you. Avoiding smoking
and eating a low-fat diet can prevent bone loss and protect your heart.
Including a lot of calcium in your diet is also good for your bone health.

How Can You Deal With Your Feelings About

Having POF?

POF, especially infertility caused due to it, may make you feel
depressed and anxious. It is always recommended that you reach out
to a counsellor and get professional support to help you get through
this difficult time.

Other Problems Due to POI

In women with POI, the ovaries aren’t able to produce enough estrogen
to support the function of the body. Estrogen is essential to keep the
blood vessels flexible and to prevent a stroke, Alzheimer’s and high
cholesterol.

FAQs

1. Can I get pregnant with Premature Ovarian Insufficiency?

If you have Premature Ovarian Insufficiency but your eggs haven’t
depleted completely yet, there is a good chance that you can still get
pregnant. Consult your doctor about any precautions that you need to
take to have a successful conception and pregnancy if you suffer from
POI.

2. What is the difference between Premature Ovarian Failure

and early menopause?

Although used interchangeably as it usually happens to women around

the same age, Premature Ovarian Failure and early menopause are
different. During menopause, your ovaries will stop ovulation
completely, which means that no eggs will be released. Also, women
are considered to be in menopause only when they haven’t had their
periods for over a year.

On the other hand, if you have a Premature Ovarian Failure, it means

that you have an ovarian dysfunction wherein your ovaries aren’t
functioning properly, but you may continue to release eggs at irregular
intervals.

Getting diagnosed with Premature Ovarian Insufficiency is hard to cope

with, especially if you are trying to conceive. Remember to reach out
for help and discuss with your doctors about any alternative options
that you have to get pregnant. With advances in technology, IVF or in-
vitro fertilisation is made possible. Check with your doctor if you are
eligible for the same or if you can get pregnant through donor eggs.
Understand your options and what it means, and make a choice that is
appropriate for you.