Premature Ovarian Failure – A Fertility Problem

Fertility problems can come as a heartbreaking hurdle in the family-planning journey of a couple trying to conceive. Premature ovarian failure which affects about 1% to 4% of the population in the US alone is one of the fertility problems that women face that prevents conception.

What is Premature Ovarian Failure (POF)?

Ovaries are responsible for releasing an egg and the hormones necessary to begin and continue a successful pregnancy. However, in the case of premature ovarian failure, also known as premature ovarian insufficiency (POI), the ovaries stop releasing eggs before you hit the age of 40. The average onset age of this condition is 27 years but it may happen to women as early as in their teens. On certain occasions, the condition is present right from birth. The risk of POF increases with age.

Causes of Primary Ovarian Insufficiency

Premature ovarian failure is often due to the loss of eggs, which may be a result of the following conditions:

• Defects in the chromosomes: Genetic condition like Turner’s syndrome and fragile X syndrome are associated with POI. In women with Turner’s syndrome, there is one normal X chromosome, but the second X chromosome is altered or missing. On the other hand, the X chromosomes in women with fragile X chromosomes syndrome are very weak and tend to break.

• Toxins: Most women who undergo radiation and chemotherapy may suffer from toxin-induced ovarian failure, as they can affect the genetic make and material that are present in cells. Cigarettes, drugs, pesticides, viruses, and chemicals may also speed up early ovarian failure.

• Autoimmune diseases: Autoimmune diseases are when the immune system in the body begins attacking the cells and tissues native to the body. When an autoimmune disease affects the ovaries, the antibodies damage the follicles in the ovaries that contain eggs. While the exact cause of this is unknown, but it is believed to be a trigger response to a virus.

• Idiopathic causes: Sometimes the cause for POI is unknown and may not be identified even on further testing.

Signs and Symptoms of Premature Ovarian Failure

Symptoms of premature ovarian failure are quite like the symptoms of menopause and include:

• Irregular periods
• Night Sweats
• Hot flashes
• Trouble sleeping
• Depression, irritability or anxiety
• Trouble concentrating
• Vaginal dryness
• Reduced sexual desire

Diagnosis and Tests

Diagnosis of POI is usually done through the following tests:

• Physical exam and a medical history will be asked for. The doctor will also inquire about your symptoms to locate the reason. You may also be given a pregnancy test to rule out pregnancy.

• Blood tests will determine the hormone levels in your body and ensure whether your ovaries are functioning properly by checking the level of follicle stimulating hormone (FSH)

• The levels of reproductive hormones like estrogen and luteinizing hormone (LH) are also determined.

• Additional tests to check for autoimmune diseases and genetic disorders are conducted.

Complications of Premature Ovarian Failure

Premature ovarian failure gives rise to the certain complications like:

• Infertility: If the eggs are completely depleted you have no chance of getting pregnant. However, in case your eggs aren’t completely depleted, you may still be able to conceive.

• Osteoporosis: Estrogen hormone help maintain the strength of the bones. Lower production of estrogen may result in weak and brittle bones which are prone to breaking.

• Depression and anxiety: As women face the risk of infertility and certain other complications due to the condition, they may go through depression and anxiety.

• Heart disease: Lack or estrogen or loss of estrogen at an early age may increase the risk of heart disease.
• Dementia: Lack of estrogen can also lead to or increase the risk of dementia in many women.

Premature Ovarian Failure Treatment

While there is no treatment to return functionality to your ovaries, there are a few options for treatment that may lower the symptoms of the condition.

• Hormone therapy is prescribed to women to add estrogen and progesterone hormones into the body. This can be done through pills, sprays, patches, gels or vaginal rings. Hormone therapy can provide hormone balance to your body and reduce your risk of conditions that may result as a result of lack of estrogen, like osteoporosis, heart disease, dementia, etc.
• Medicines may be prescribed to prevent hot flashes.
• Women may also opt artificial insemination methods like in-vitro fertilization (IVF) or get donor eggs to achieve pregnancy.

How to Prevent Premature Ovarian Failure?

Although there is no definitive way to prevent premature ovarian failure, you can reduce the risk of complications like heart disease, osteoporosis, etc, by maintaining a healthy lifestyle. A good, balanced diet and regular exercise can be beneficial to you. Avoiding smoking and eating a low-fat diet can prevent bone loss and protect your heart. Including a lot of calcium in your diet is also good for your bone health.

How Can You Deal With Your Feelings About Having POF?

POF, especially infertility caused due to it, may make you feel depressed and anxious. It is always recommended that you reach out to a counsellor and get professional support to help you get through this difficult time.

Other Problems Due to POI

In women with POI, the ovaries aren’t able to produce enough estrogen to support the function of the body. Estrogen is essential to keep the blood vessels flexible and to prevent stroke, Alzheimer’s and high cholesterol.

FAQs

1. Can I get pregnant with premature ovarian insufficiency?

If you have premature ovarian insufficiency, but your eggs haven’t depleted completely yet, there is a good chance that you can still get pregnant. Consult your doctor about any precautions that you need to take to have a successful conception and pregnancy if you suffer from POI.

2. What is the difference between premature ovarian failure and early menopause?

Although used interchangeably as it usually happens to women around the same age, premature ovarian failure and early menopause are different. During menopause, your ovaries will stop ovulation completely, which means that no eggs will be released. Also, women are considered to be in menopause only when they haven’t had their periods for over a year.

On the other hand, if you have a premature ovarian failure, it means that you have an ovarian dysfunction wherein your ovaries aren’t functioning properly, but you may continue to release eggs at irregular intervals.

Getting diagnosed with premature ovarian insufficiency is hard to cope with, especially if you are trying to conceive. Remember to reach out for help and discuss with your doctors about any alternative options that you have to get pregnant. With advances in technology, IVF or in-vitro fertilization is made possible. Check with your doctor if you are eligible for the same or if you can get pregnant through donor eggs. Understand your options and what it means and make a choice that is appropriate for you.