Premature Ovarian Failure
Premature ovarian failure (POF) can be a devastating condition for women � especially for those still wishing to become pregnant. Considered a fairly rare condition, POF currently affects approximately 1 in every 1,000 women between the ages of 15 and 29 and 1 in every 100 women between the ages of 30 and 39. Although POF is often used interchangeably with premature menopause, the two conditions are not exactly the same. Unlike menopause, POF does not result in the permanent loss of ovarian function. In fact, in some cases it is actually reversible.
Premature Ovarian Failure vs. Premature Menopause
POF occurs when the ovaries stop working properly, usually due to loss or dysfunction of egg follicles. Women who have premature menopause, on the other hand, will no longer have a period. As a result, they will no longer be able to conceive a child, as their ovaries are no longer ovulating, or producing any eggs.
In addition, while women with POF may not have regular periods � they can often go months without one � they are usually prone to sporadic regular cycles for a period of several months. Women with premature menopause will no longer receive a normal period. However, hormone levels in a woman with POF may be similar to those of a menopausal woman. The problem is that, while high follicle stimulating hormone (FSH) and low oestrogen levels are normal for a menopausal woman, they are not normal in a woman with POF.
The reason the two conditions are so often confused is because they share some of the same signs and symptoms. Some symptoms of premature ovarian failure include:
- Amenorrhea (cessation of period) or irregular periods
- Hot flashes and night sweats
- Sleep problems
- Irritability
- Vaginal dryness
- Loss of energy
- Loss of sex drive
- Painful sex
- Bladder problems
- Infertility
Why Causes POF?
Put simply, POF is caused by a lack of so-called responsive follicles in your ovaries, or when these follicles are not working properly. Causes of unresponsive follicles (or follicle depletion) include chromosomal defects, which can result from disorders such as Turner�s syndrome and fragile X syndrome, as well as certain toxins, such as those from chemotherapy and radiation treatments.
Follicle dysfunction may occur if a woman has a low amount of follicles or an abnormal autoimmune reaction that causes the body to attack developing follicles.
In most cases, however, the exact of cause of premature ovarian failure is unknown.
When to Seek Medical Attention
Period regularity is a good indicator of your overall reproductive health. If you are experiencing missed or abnormal menstrual cycles, you should consult with your doctor.
To diagnose POF, the doctor must perform a blood test that measures the level of follicle stimulating hormone (FSH) in your blood. Normally, it is necessary to have not have had a period for four consecutive months before POF can be accurately diagnosed. You will probably need to do two FSH blood tests about a month apart. A diagnosis of POF is often made if your results show your FSH levels to be above 40mlU/ml. In some cases, doctors will diagnose POF with FSH levels above 30mlU/ml.
Getting diagnosed with POF is a crucial first step in seeking treatment for this condition. Left untreated, POF can contribute to other health problems, such as osteoporosis, heart disease, thyroid problems, diabetes as well as adrenal problems.
Treatment for POF
As is the case for menopause, the most common treatment for POF is hormone replacement therapy (HRT), although the doses of oestrogen and progesterone (and occasionally testosterone) are generally higher than HRT prescribed during menopause.
The medical community is still largely conflicted over how long HRT can safely be used in menopause, but most experts agree that hormone treatment is safer for women with POF, since it is being used to replace hormone levels that these women should have naturally.
This process of raising the amount of oestrogen and progesterone back to natural levels, usually causes women with POF to begin having regular periods again. Hormone therapy can also help to lower a woman�s chances of osteoporosis.
In some cases, doctors may prescribe the birth control pills to provide increased levels of oestrogen and progesterone.
POF and Getting Pregnant
What can make POF so devastating is the fact that a woman�s odds of getting pregnant become drastically reduced because of this condition. In fact, only 5 to 10 percent of women with POF will be able to become pregnant naturally. That is why most women diagnosed with POF are recommended to seek infertility treatment, such as fertility drugs, or assisted reproductive technologies, such as in vitro fertilization (IVF).
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