Table of Contents
Definition of Premature Ovarian Failure (POF)
Though POF causes menopause-like symptoms and people (including doctors) sometimes refer to it as premature menopause, women who have POF often have irregular menstrual cycles for years after the onset of POF symptoms and do retain the ability to conceive, whereas menstrual cycles completely cease with menopause, ending the potential for pregnancy.
The reasons for POF are unclear though likely are a mix of genetic, hormonal, and perhaps autoimmune factors. Women who have POF have lower than normal levels of estrogens and higher than normal follicle-stimulating hormone (fsh) levels in the blood circulation, suggesting depletion or dysfunction of the ovarian follicles.
Doctors do not know whether the abnormal hormone levels cause or result from follicular factors. Chromosomal disorders such as Turner’s syndrome and genetic disorders such as achondroplasia (a form of skeletal dysplasia, often called dwarfism) also are associated with POF.
Symptoms and Diagnostic Path
The symptoms of POF are similar to those of menopause and commonly include
- Hot flashes and night sweats
- Vaginal dryness and irritation (nonbacterial vaginitis)
- Painful sexual intercourse (dyspareunia)
- Diminished libido
- Low energy or fatigue
- Irritability and mood swings
- Irregular menstrual periods
The diagnostic path begins with a comprehensive medical examination, including pelvic examination, and blood tests to measure blood hormone levels (usually including a pregnancy test). The doctor may desire genetic tests as well, such as a karyotype, to evaluate the possibility of a genetic or chromosomal disorder.
Women who have very mild Turner’s syndrome may first learn of this diagnosis during evaluation for POF, as other symptoms of the syndrome may be so nominal as to escape detection.
Treatment Options and Outlook
Treatment with estrogen and progestin supplementation until closer to the age for natural menopause may relieve many POF symptoms though does not usually improve fertility. However, pregnancy remains possible and is something a woman should consider when her menstrual period does not occur as expected when she is taking hormone supplementation.
Women who have POF have increased risk for osteoporosis and cardiovascular disease (cvd), and should follow lifestyle practices to support bone and cardiovascular health. Such practices include calcium supplementation, daily physical exercise such as walking or running for cardiovascular health, resistance activities such as lifting weights to maintain muscle mass and bone density, nutritious eating habits, and weight management.
Risk Factors and Preventive Measures
Known risk factors for POF are chromosomal or genetic disorders affecting the sex chromosomes or features of sexual development and Addison’s disease (an autoimmune disorder affecting the adrenal glands). Medical treatments such as chemotherapy and radiation therapy may cause secondary POF. There are no known measures to prevent POF.
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