It is basically known as having ovarian failure before reaching the age of 40 years old. It used to be thought of as just another term for having premature menopause, but no longer. It is also known as Premature Ovarian Failure or (POF).
POI is when a woman does not get her monthly menstrual cycles, or gets them irregularly. The difference between this and premature menopause, has to do with the fact that a woman who has POI, will probably still retain some form of sporadic ovarian function for several years to come. And because of this, women with primary ovarian insufficiency may also get pregnant, despite having difficulties with fertility and trying to conceive. Women who have experienced premature menopause will not.
A woman, who has normal ovarian function, releases certain hormones from her pituitary gland, during each of her monthly cycles. This process then causes some egg-containing follicles in the ovaries to begin to mature, usually one per month. Once mature, the follicle will then burst open and release the egg, traveling to and entering the fallopian tube, where it will wait for the possibility of being fertilized by a sperm.
This condition occurs as the result of either follicle dysfunction or follicle depletion.
Follicle dysfunction can be the result of your immune system possibly producing antibodies against your own ovarian tissue, which can damage the egg-containing follicles and its egg. No one is certain as to just what it is that produces this immune response; however, one thought is the possible exposure to a virus. If you have been tested and do not have an autoimmune disease, further testing will probably be necessary.
Follicle depletion is usually caused by two main issues, and they are chromosomal defects and toxins. There are specific genetic disorders that seem to be connected with POI and they include:
- Fragile X Syndrome: An intellectual development disorder, formerly known as mental retardation.
- Turner’s Syndrome: Instead of a woman having two X chromosomes, she has only one.
The two most common causes of toxin-induced ovarian insufficiency are due to either chemotherapy or radiation therapy, which can harm the genetic material in cells. Other types of toxins can hurry the condition of ovarian failure along and include:
- Cigarette Smoke
Here are some of the symptoms that can signal you may be having this problem, though keep in mind you could also be going into premature menopause as well. They include:
- Irregular or skipped periods (also known as amenorrhea)
- Night sweats
- Decreased sexual desire
- Hot flashes
- Problems with vaginal dryness
- Difficulty concentrating or irritability
- Painful Intercourse due to thinning of the vaginal walls and vaginal inflammation
There are several problems that result from having this condition. The most emotional and well-known of these problems is, of course, infertility. Women who want children and encounter this issue, often find it very difficult to deal with. Approximately 5 to 10% of women with this condition become pregnant spontaneously, with no medical intervention at all. But for those who do not, there are a few things that can be tried in order to conceive a child. The best option for women with this particular condition is in vitro fertilization with donor eggs. The success rates for this procedure are quite high, but seem to center primarily on the age of the egg donor. Another possible option is embryo donation, which is where a frozen embryo is donated to the woman or couple trying to conceive. This is somewhat less expensive than in vitro and also has a high success rate. Unlike some other conditions that cause infertility, POI does not seem to improve or respond to treatment with fertility drugs, other hormones or estrogen, as far as fertility is concerned, which keeps a woman’s chances at conceiving easily or normally, extremely low.
Another problem that often results from this condition is osteoporosis. Because estrogen helps to maintain strong bones, women who suffer from primary ovarian insufficiency are at a greater risk for developing osteoporosis, due to their low levels of estrogen. One thing that can be done to help prevent this problem, is to have estrogen-progestin therapy until a woman reaches the age of at least 50 years old, as this is the approximate time that most women naturally go into menopause. (The addition of the hormone progesterone will help to protect the lining of a woman’s uterus from precancerous changes that can be created by simply taking estrogen alone.) This will not only help to prevent osteoporosis but also possibly cardiovascular disease. In addition, this will also help to reduce some menopausal symptoms that can include vaginal dryness, hot flashes and night sweats. Something else that can help to prevent osteoporosis is making certain that you have enough of both vitamin D and calcium. If you are not receiving enough of either of these, your doctor may recommend that you begin taking supplements.
Women who have been diagnosed with this condition have also been known to become very depressed or anxious. Part of this has to do with the possibility of infertility and part has to do with the other issues that could arise from having low estrogen levels (cardiovascular disease, osteoporosis).
This diagnosis can be difficult to deal with and may take you some time from which to recover, however, talking with other women and couples who are going through the same situation can often help. Allow yourself time to grieve and time to deal with any of the problems that may have arisen from this unexpected condition. Don’t try to overcome everything at once and ask your doctor any questions that you feel you need to, in order to solve and get past your issues.