Do you experience hot flashes? What about skipped periods, or unexpected/irregular periods that inconvenience your life? These common symptoms of menopause are troublesome enough when you are a woman “of a certain age” and are expecting them, but if you are under the age of 40, those symptoms warrant a deeper look.
Premature Ovarian Failure (POF) affects 1 in 100 women under 40 and requires a full evaluation from a gynecologist or reproductive endocrinologist (RE).
What Are the Most Common Symptoms of Premature Ovarian Failure?
The most common symptoms of Premature Ovarian Failure are similar to what many women experience in menopause or with estrogen deficiency:2
- Irregular or skipped periods (amenorrhea), which could be present for years or develop after a pregnancy or after stopping birth control pills
- Difficulty conceiving
- Hot flashes
- Night sweats
- Vaginal dryness
- Irritability or difficulty concentrating
- Decreased sexual desire
What Causes Premature Ovarian Failure?
Premature Ovarian Failure has a variety of causes, but in about 90% of cases, the cause is not known.3 The most common cause is a history of cancer treatment, including radiation or chemotherapy. Autoimmune issues can also cause Premature Ovarian Failure, if the body’s immune system attacks organs of the endocrine system such as ovaries, thyroid or adrenal glands.1 Premature Ovarian Failure can result from deficiencies in pituitary and ovarian hormones.1
Am I at Risk for Premature Ovarian Failure?
There are three main categories of risk factors for Premature Ovarian Failure:
- Age – Though it is possible for adolescent and younger women to develop Premature Ovarian Failure, your risk increases between the ages of 35 and 40.2
- Family history – If you have a family history of premature ovarian failure, you are at increased risk. In this case, your doctor should do a full evaluation to determine what syndromes or other serious potentially serious medical issues might be present.1,2
- Multiple ovarian surgeries – if you have had repeated surgeries for issues like ovarian endometriosis or other conditions you are at increased risk.2
If you identify with these three risk factors, or if you have received chemotherapy for cancer treatment in the past, you should consult your gynecologist or reproductive endocrinologist to discuss your individual risk, and any necessary measures you should take.
How Does Premature Ovarian Failure Affect My Fertility?
One of the primary complications of Premature Ovarian Failure is difficulty conceiving.1,2 The deficiency of estrogen and the failure to produce eggs healthy enough for conception results in a loss of fertility.1,2 You must seek treatment from a doctor that specializes in infertility, like a reproductive endocrinologist (RE).
What Are My Options for Treatment of Premature Ovarian Failure?
Once your doctor has diagnosed Premature Ovarian Failure, he or she will recommend treatment plan based on your symptoms and goals. Work closely with your doctor to find what path of care feels right and comfortable for you. Educate yourself about the condition and talk honestly about how you feel regarding side effects, complications, and outcomes of whatever treatment you choose together.
- Hormone Therapy – Replacement of the hormone estrogen may be useful in reducing hot flashes, restoring regularity of your monthly cycle, and preventing osteoporosis, which is a common complication of estrogen deficiency).2
- Vitamin Supplements and Nutritional Support – Calcium and Vitamin D are helpful in prevention of osteoporosis. Focus on a healthy diet and regular exercise are also good for preventing weight gain, heart disease and bone health.2
- Mental Health Support– It is not uncommon for a woman diagnosed with Premature Ovarian Failure to struggle with grief or depression. Find a mental health professional who can help you work through your feelings about this disease and find coping skills.
For a comprehensive discussion on the causes and treatment of Premature Ovarian Failure, listen to this podcast from Creating a Family https://creatingafamily.org/infertility-category/premature-ovarian-failure-causes-and-treatment/ with Dr. Timothy Hickman, Medical Director of Houston IVF, a Board Certified Reproductive Endocrinologist, and former member of the Executive Board of the Society for Assisted Reproductive Technology.
- Ebrahimi M, Akbari Asbagh F. Pathogenesis and Causes of Premature Ovarian Failure: An Update. International Journal of Fertility & Sterility. 2011;5(2):54-65. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059950/. Accessed October 11, 2017.
- Premature Ovarian Failure. Mayo Clinic Staff. Published October 27, 2016. Available at: Accessed http://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/dxc-20255567. Accessed October 11, 2017.
- From National Institute of Health, Eunice Kennedy Shriver’s National Institute of Child Health and Human Development, https://www.nichd.nih.gov/health/topics/poi/conditioninfo/Pages/causes.aspx
-  From Resolve.org, Premature Ovarian Failure – What Do I Need to Know? http://www.resolve.org/about-infertility/medical-conditions/premature-ovarian-failure-what-do-i-need-to-know.html