Premature ovarian failure is also called premature ovarian insufficiency (POI). If you are a woman under the age of 40 and you suddenly experience an absence of menses for a prolonged time, then it could be due to a frightening scenario called premature ovarian failure in the absence of pregnancy. Let’s examine this new term in detail in this blog.
What is premature ovarian failure?
Normally, we refer to a group of women who experience cessation of menses for more than 1 year before 40 by different terms. These include primary ovarian insufficiency, premature ovarian menopause or premature ovarian failure. These distinct illness are commonly confused by many women. Ovaries are tiny oval almond shaped glands that are situated on either side of the uterus. During ovulation, they make and release eggs
Menopause is the complete absence of menses as a part of ageing i.e., what happens during menopause. It happens because of the depletion of ovarian follicles and occurs around 47-51 years. When there is depletion or dysfunction of ovarian follicles with stoppage of menses at an earlier age before menopause then we call this condition as premature ovarian failure(premature menopause)
Symptoms of POI:
Some common symptoms of POI that women face apart from the absence or irregular menses are
*Vaginal dryness
*Irritability
*Night sweats
*Difficulty in sleeping
Factors which contribute to premature ovarian failure:
There are many contributing factors which include
*Surgery: Ovarian surgeries such as the removal of ovaries or pelvic surgery resulting in impairment of ovarian function
*Chemotherapy or radiotherapy used in cancer treatment
*Autoimmune conditions- Problems with thyroid and adrenal glands
* Genetic causes –Turner syndrome or Fragile X syndrome
*Infections-An antibody attack on your ovary is believed to be the cause of this(eg mumps)
*Unknown factors- The exact reason for POI is still not known in some cases even after performing many tests.
How to diagnose?
If you think, you have premature ovarian failure, you should consult your gynaecologist specialising in Reproductive Endocrinology/Fertility Specialist. She will guide you in diagnosis and further management. Generally, primary ovarian insufficiency (POI) affects 1% of women. Among patients with amenorrhea (absence of menses), the incidence of POI is almost 2% to 10%. These women can also present with an abnormal bleeding pattern as oligomenorrhea (bleeding less frequently than every 35 days) or polymenorrhea (bleeding that occurs more often than every 21 days) for more than 4 months duration.
Your fertility specialist can diagnose POI more accurately if they are aware of your regular menstrual cycle, previous pregnancies, or usage of birth control. When you suspect POI, you will be asked to take blood tests such as serum AMH,FSH and Estradiol. This test is used to measure levels of hormones such as FSH (Folecule-stimulating hormone) and Estradiol. If the FSH levels are elevated in the menopausal range (greater than 30-40 mIU/ml), then do a repeat FSH in 1 month. Estradiol levels will be usually less than 50 pg/ml.
Chance of pregnancy:
Some women begin to have POI as teenagers, even before they begin menstruating. They don’t go through the typical puberty stage. For other women, the ovaries may intermittently release eggs and make hormones. These women have difficulty getting pregnant which may be considered a sign of POI. Despite having POI, there is a 5% to 10% possibility of spontaneous conception because there is a small probability of ovarian function returning on its own.
To Conclude:
Thus, in almost half of the women with POI, the exact cause is not known. A close family member’s history of POI (such as a mother or sister) should prompt the family and a fertility specialist to look for other family members who may be at risk. Hence, speak with your fertility specialist about the proper management of premature ovarian failure, and live life to the fullest.
