Download Understanding Premature Ovarian Failure

Understanding Premature Ovarian Failure (POF) & Early Menopause
Menopause is simply the name given to a woman’s last menstrual period. However,
it is the cycle in a woman's life when her ovaries stop producing eggs, when her
periods begin to stop and when her hormone levels change. Menopause is
something that typically happens between the ages of 47 and 53. It means hot
flushes, no more periods, an end to a woman’s reproductive years.
What is POF?
Premature ovarian failure, which is also known as primary ovarian insufficiency,
refers to a loss of normal function of your ovaries prior to menopause (before the
age of 40). Premature ovarian failure and premature menopause are often used
interchangeably, which although may be confusing essentially mean the same thing.
Normally the ovaries produce estrogen and progesterone in response to other
follicle stimulating hormone (FSH) and luteinising hormone (LH) which are made in a
part of the brain called the pituitary gland. All these hormones interact as part of the
monthly menstrual cycle that results in the development of an egg in one of the
ovaries. In POF, the ovaries stop producing normal levels of estrogen disrupting the
production of eggs.
What are the symptoms of POF?
Periods may become infrequent or stop which can result in infertility. There may also
be other symptoms such as:
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Hot flushes and night sweats
Insomnia/disrupted sleep
Palpitations
Weight gain (especially around waist and abdomen)
Skin and hair changes (dryness, thinning)
Headaches
Breast tenderness
Mood swings and irritability
Anxiety/panic attacks
Loss of self-esteem
Lowered libido
Difficulty concentrating and memory lapses
Fatigue/low energy levels
Joint/muscle pain
Vaginal dryness and urinary infections
Depression
How is POF diagnosed?
Women with POF usually have raised FSH levels and low levels of estrogen. This is
because in premature ovarian failure the ovaries do not produce normal levels of
estradiol so the pituitary reacts by making more FSH to try to stimulate the ovaries
to produce estradiol. Your FSH and estradiol levels can be measured by a simple
blood test.
If you are still having periods, it is very important that the blood test is done at the
correct time in the cycle (the beginning – day 2 to 4 of your period) because FSH
goes up later on in a normal cycle.
If you are no longer having periods, you can have the test on any day. It is also
important that the blood test is performed twice, at least four weeks apart, to
confirm the diagnosis.
What are the causes of POF?
POF can be caused by:
 Chemotherapy or radiotherapy
 Ovarian removal during an operation
 Chromosomal or gene problems
 As a result of some autoimmune diseases such as diabetes or thyroid disease
However, usually there is no known cause – this known as idiopathic premature
ovarian failure.
What are some of the treatment options available?
Treatment for primary ovarian insufficiency will help you manage your symptoms.
But there is currently no treatment that will make the ovaries start to work properly
again. Most specialists recommend that women with premature ovarian failure take
an estrogen replacement because the estrogen level is very low and this can cause
bone thinning and an increase in cardiovascular risk, as well as causing many of the
symptoms mentioned above.
Estrogen replacement can be given as HRT (hormone replacement therapy) or the
combined oral contraceptive pill. There are many different types of HRT and pills and
are given in a variety of combinations to suit the needs of each individual woman
and alleviate her particular symptoms.
It is important to remember that not all treatments will suit every woman, if the first
treatment is not suitable there are likely to be alternatives. Additionally, for a
woman being diagnosed with POF can be extremely upsetting, especially for a
woman who hopes to become pregnant. There are various support groups and
counseling services available.
Useful links & Websites
http://www.daisynetwork.org.uk
www.pofsupport.org.
http://natural-fertility-info.com/premature-ovarian-failure.html