The Journal of Clinical Endocrinology & Metabolism Vol. 93, No. 2 0
Copyright © 2008 by The Endocrine Society
Patient Information Page from The Hormone Foundation |
Premature Ovarian Failure
Marcel Cedars, MD,
William Evans, MD and
Nanette Santoro, MD
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What is premature ovarian failure?
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Premature ovarian failure (POF), sometimes called premature ovarian insufficiency, occurs when the ovaries (the twin female organs that produce and release an egg each monthly cycle) stop working before a woman turns 40. When they stop working, women don’t ovulate or produce normal amounts of the hormone estrogen, which puts them at risk for serious conditions such as osteoporosis and heart disease, as well as infertility.
In the United States, POF affects about 1 in every 100 women. The most common signs of POF are irregular or missed menstrual periods—especially if they are accompanied by hot flashes. Periods may occur off and on, or may start again many years after being diagnosed with POF. Other symptoms may include:
- Night sweats
- Vaginal dryness
- Irritability
- Difficulty concentrating
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How is POF caused?
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In most cases the cause of POF is unknown. Some genetic disorders (such as Turner syndrome and Fragile X syndrome) are associated with POF. Also, exposure to toxins (e.g., through chemotherapy and radiation therapy) can damage genetic material in cells and lead to POF.
The risk of developing POF increases if you have a family history of the disorder.
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What are the risks associated with POF?
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Because women with POF have low levels of estrogen, several health conditions are more common in them than in women without the disorder: - Infertility. Most women with POF cannot get pregnant; a small number (about 10%) can conceive on their own. There are no known fertility treatments that are effective for POF.
- Osteoporosis. Low levels of estrogen increases the risk of developing brittle bones due to bone loss, which puts women at an increased risk for fractures.
- Heart disease. Low levels of estrogen early in life may increase the risk of heart attack.
- Depression. Many women who develop POF experience a lingering sadness about their unexpected loss of ovarian function. Women with POF may want to talk to a therapist or may benefit from medication for depression, if the symptoms are severe.
If you have POF, you may also be at increased risk for autoimmune failure of other endocrine glands. Women with POF should be checked periodically for deficiencies in thyroid, adrenal gland, and other gland function.
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How is POF diagnosed?
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If you are younger than 40 and have stopped having periods or are having irregular ones, talk to your doctor to find the cause of the problem. Your doctor will first ask about your menstrual history and any menopause-like symptoms you may be experiencing. Blood tests will then be done to determine if your ovaries are working properly. Additional tests should also be done to check for possible genetic or autoimmune conditions that may be related to the ovarian failure. An endocrinologist, a specialist in hormone-related conditions, can help diagnose and treat POF.
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How is POF treated?
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Treatment depends on whether or not symptoms are present and whether or not a woman with POF has significant health risks to warrant therapy. Hormone therapy (HT) is the most common treatment. HT relieves menopausal symptoms and also helps prevent osteoporosis. HT can be taken as a pill or applied to your skin as a gel or patch. In older, postmenopausal women, HT may increase risk of breast cancer, heart disease and stroke. Usually, HT can be safely stopped when a woman with POF reaches the age of natural menopause. Women who cannot or do not wish to take HT may benefit from non-hormonal treatments. In addition to medical treatment, women with POF should eat a healthy diet and exercise regularly to decrease the risks of osteoporosis and heart disease.
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Resources
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- To find an endocrinologist: www.hormone.org or call 1-800-HORMONE (1-800-467-6663)
- International Premature Ovarian Failure Support Group: www.pofsupport.org
- Medline Plus (NIH): www.nlm.nih.gov/medlineplus/prematureovarianfailure.html
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Footnotes
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For more information on how to find an endocrinologist, download free publications, translate this fact sheet into other languages, or make a contribution to The Hormone Foundation, visit www.hormone.org or call 1-800-HORMONE (1-800-467-6663). The Hormone Foundation, the public education affiliate of The Endocrine Society (www.endo-society.org), serves as a resource for the public by promoting the prevention, treatment, and cure of hormone-related conditions. This page may be reproduced non-commercially by health care professionals and health educators to share with patients and students.
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What is premature ovarian...
How is POF caused?
