Premature ovarian failure - Vitality Hormone Clinic

What is premature ovarian failure?

Premature ovarian failure (POF), also known as primary ovarian insufficiency, is a disorder characterized by loss of normal ovarian function before the age of 40. This results in infertility, irregular or missed periods, and menopausal symptoms like hot flashes and vaginal dryness.

Some key facts about POF:

• It affects roughly 1% of women under age 40.
• The cause is often unknown, but can include genetics, autoimmune disorders, infections, cancer treatment, and more.
• Women with POF typically have low estrogen levels and high follicle-stimulating hormone (FSH) levels.
• There is no cure, but hormone therapy can help manage symptoms.

Symptoms

The main symptom of POF is irregular periods or amenorrhea (lack of periods):

• Periods may be light, heavy, irregular, or entirely absent
• Many women notice hot flashes, night sweats, vaginal dryness, and pain during sex - signs of early menopause

Some women may struggle to get pregnant or experience recurrent miscarriages. Testing shows high FSH and low AMH/inhibin B levels.

Causes

Doctors often can't pinpoint the exact cause of POF. Known contributors include:

• Genetic factors - chromosomes or genes associated with POF that run in families
• Autoimmune disease - immune system attacking ovarian tissue
• Cancer treatment like chemotherapy or radiation therapy
• Viral infections like mumps or HIV
• Metabolic disorders like galactosemia
• Idiopathic - no known cause

Diagnosis and Testing

POF is diagnosed through:

• Medical history - age, menstrual cycle details, sexual development
• Physical exam - pelvic exam to check ovaries and uterus
• Hormone tests - FSH, estradiol, AMH levels
• Genetic testing - karyotype or panel tests

Doctors need to rule out other causes of amenorrhea like pregnancy, anorexia, excessive exercise, tumors, or thyroid problems. Repeat testing of FSH and estradiol is done to confirm ovary hypofunction.

Treatment and Outlook

Unfortunately there is no proven way to regain normal ovarian function once diagnosed with POF. But treatments can help manage symptoms:

• Hormone therapy - estrogen/progestin pills, patches, gels, rings, shots
• Egg or embryo freezing at younger ages for later family building
• Donor eggs or embryos for getting pregnant
• Counseling and online support groups