Description

Primary ovarian insufficiency occurs when the ovaries stop working as they should, before 40 years of age. When this happens, the ovaries do not make the typical of the quantities of the hormone estrogen or release eggs regularly. The condition often leads to infertility. Another name for the primary ovarian failure is the premature ovarian failure. Also used to be called premature ovarian failure, but this term is no longer used.

Sometimes, the primary ovarian failure is confused with premature menopause. But they are not the same. People with primary ovarian failure may have irregular or occasional periods for years. You might even get pregnant. But people with premature menopause stop having periods and can't become pregnant.

The treatment can restore the estrogen levels in people with primary ovarian failure. This helps to prevent some of the conditions that can occur due to low levels of estrogen, such as heart disease and weak, fragile bones.

Symptoms

The symptoms of primary ovarian insufficiency are similar to those of menopause or low estrogen. They include:

  • Irregular or absence of menstrual period. This symptom may be present for years. It can also develop after a pregnancy or after you stop birth control pills.
  • Trouble getting pregnant.
  • Hot flashes and night sweats.
  • The Vaginal dryness.
  • Anger, depression, or anxiety.
  • Problems with the approach or the memory.
  • Less sexual desire.

When to see a doctor

If you've lost your period for three months or more, talk to your health care team to find out the cause. You can lose your period for many reasons, such as pregnancy, stress, or a change in diet or exercise habits. But the best thing is to get a health care check-up each time one of your changes in the menstrual cycle.

Even if you don't mind not having periods, consult a health care professional to find out what is causing the change. Low levels of estrogen can lead to a condition that causes weak and fragile bones, called osteoporosis. Low levels of estrogen can also lead to heart disease.

Causes

Primary ovarian insufficiency can be caused by:

  • Changes in the chromosomes. Chromosomes are thread-like structures that contain the genes. Most often, the people who are assigned female at birth have two X chromosomes in their cells. But some people with primary ovarian insufficiency have one X chromosome and an alteration of chromosome X. This may be a sign of genetic diseases such as Turner syndrome mosaic. Other people with primary ovarian insufficiency have X chromosomes that are fragile and break. This is called the fragile X syndrome.
  • Toxins. Chemotherapy and radiotherapy are the most common causes of toxin-induced ovarian failure. These treatments can damage the genetic material in cells. Other toxins, such as cigarette smoke, chemicals, pesticides, and the virus could accelerate ovarian failure.
  • A response of the immune system in the ovarian tissue. This is also called autoimmune disease. In this rare form, the immune system of protective proteins that attack ovarian tissue by mistake. This hurts the sacs in the ovaries, which each contain an egg, called follicles. It also damages the egg. What triggers the immune response is not clear. But being exposed to a virus may play a role.
  • Unknown factors. Most often, the cause of primary ovarian insufficiency is unclear. You could be listening to this as an idiopathic cause. Your health care professional may recommend more tests to try to find the cause.

Risk factors

The factors that increase the risk of primary ovarian insufficiency include:

  • Age. The risk increases between the ages of 35 and 40. Primary ovarian insufficiency is rare before 30 years of age. But the young men, and even teens can access it.
  • The history of the family. Having a family history of primary ovarian failure, increases the risk of getting this condition.
  • Ovarian surgery. The surgeries that involve the ovaries increase the risk of primary ovarian insufficiency.

Complications

Primary ovarian insufficiency can lead to other health problems, including the following:

  • The infertility. Not being able to get pregnant can be a complication of primary ovarian insufficiency. Rarely, pregnancy is possible, until the body's supply of eggs is finished.
  • Osteoporosis. This condition causes bones to become weak, brittle and more prone to breaking. Women with low levels of the hormone estrogen have an increased risk of developing osteoporosis. That's because estrogen helps to maintain strong bones.
  • Depression or anxiety. Some people with primary ovarian insufficiency depressed or anxious. This may be due to the risk of infertility, and other conditions that arise from the low levels of estrogen.
  • A heart or blood vessels. The early loss of estrogen can increase the risk of heart disease or a stroke.
  • Dementia. This is the term for a group of symptoms affecting memory, thinking and social skills. The risk of developing dementia may be linked with the attainment of both ovaries and not receiving estrogen therapy after in persons under age of 43 years.
  • Parkinson's disease. This long-term condition affecting the nervous system, which includes the brain and the spinal cord. It also affects the parts of the body controlled by the nerve. The increased risk of Parkinson's disease can also be linked with the surgery to remove the ovaries.

Treatment for primary ovarian failure helps to prevent these other health conditions.

Diagnosis

Most women have few signs of primary ovarian insufficiency, but your doctor may suspect the disease if you have irregular periods or are having trouble conceiving. The diagnosis usually involves a physical exam, including a pelvic exam. Your doctor may ask you questions about your menstrual cycle, exposure to toxins, such as chemotherapy or radiotherapy, and previous ovarian surgery.

Your doctor may recommend one or more tests to check:

  • Pregnancy. A pregnancy test checks for an unexpected pregnancy if you are of childbearing age and have missed a period.
  • The levels of the hormone. Your doctor can measure the levels of certain hormones in the blood, including the follicle-stimulating hormone (FSH), a type of estrogen called estradiol, and the hormone that stimulates breast milk production (prolactin).
  • Changes in the chromosomes or genes. You can have a blood test called a karyotype analysis to look for unusual changes in their chromosomes. Your doctor may also check to see if you have a gene associated with fragile X syndrome called FMR1.

Treatment

Most often, the treatment of the primary ovarian failure focuses on the problems that arise from the deficiency of estrogen. (1p3) Treatment might include:

  • Estrogen therapy.Estrogen therapy can help to prevent osteoporosis. It can also relieve hot flashes and other symptoms of low estrogen levels. What is more likely to be prescribed estrogen and the hormone progesterone, if you still have your uterus. The addition of progesterone protects the lining of the uterus, called the endometrium, of the changes that could lead to cancer. These changes can be caused by taking estrogens alone. The combination of hormones that can cause your period to come back. Do not restore your ovaries function. Depending on your health and preference, you can take the hormone therapy until around the age of 50 or 51. This is the average age of the natural menopause. In older women, long-term oestrogen-and progesterone treatment has been associated with an increased risk of heart disease and diseases of the blood vessels, and breast cancer. In young people with primary ovarian insufficiency, the benefits of hormone therapy outweigh the risks.
  • Calcium supplements and vitamin D. Both nutrients are the key to the prevention of osteoporosis. And it is possible that you do not get enough in your diet or sunlight. Your health care team may suggest an X-ray test that measures calcium and other minerals in the bones before you start taking supplements. This is called a bone density test. For women between the ages of 19 to 50, the majority of the experts often recommend 1,000 milligrams (mg) of calcium a day, through food or supplements. The amount increases to 1,200 mga day for women age 51 years of age. The ideal of the daily dose of vitamin D is not yet clear. A good starting point is 800 to 1,000 international units (IU) per day, through food or supplements. If your blood levels of vitamin D are low, your health care team might suggest, in larger amounts.

Estrogen therapy. Estrogen therapy can help to prevent osteoporosis. It can also relieve hot flashes and other symptoms of low estrogen levels. What is more likely to be prescribed estrogen and the hormone progesterone, if you still have your uterus. The addition of progesterone protects the lining of the uterus, called the endometrium, of the changes that could lead to cancer. These changes can be caused by taking estrogens alone.

The combination of hormones that can cause your period to come back. Do not restore your ovaries function. Depending on your health and preference, you can take the hormone therapy until around the age of 50 or 51. This is the average age of the natural menopause.

In older women, long-term oestrogen-and progesterone treatment has been associated with an increased risk of heart disease and diseases of the blood vessels, and breast cancer. In young people with primary ovarian insufficiency, the benefits of hormone therapy outweigh the risks.

Calcium supplements and vitamin D. Both nutrients are the key to the prevention of osteoporosis. And it is possible that you do not get enough in your diet or sunlight. Your health care team may suggest an X-ray test that measures calcium and other minerals in the bones before you start taking supplements. This is called a bone density test.

For women between the ages of 19 to 50, the majority of the experts often recommend 1,000 milligrams (mg) of calcium a day, through food or supplements. The amount increases to 1,200 mg daily for women age 51 years of age.

The ideal of the daily dose of vitamin D is not yet clear. A good starting point is 800 to 1,000 international units (IU) per day, through food or supplements. If your blood levels of vitamin D are low, your health care team might suggest, in larger amounts.

To address infertility

There is no proven treatment to restore fertility. But some people with primary ovarian failure and their partners try to get pregnant through a procedure called in vitro fertilization. The procedure involves removing eggs from a donor and fertilizing them with sperm. A fertilized egg, called an embryo, is then placed in the uterus.

Lifestyle and home remedies

The learning that you have primary ovarian failure can be emotionally painful. But with the right treatment and self-care, you can expect to live a healthy life.

  • Learn about other ways of having children. If you would like to add to your family, talk with a health care professional about your options. For example, you might think about trying in vitro fertilization with donor eggs. Or you could adopt a child.
  • Talk with your health care team about the best birth control options. A small percentage of people with primary ovarian failure do to get pregnant if you have sex without a condom. If you do not want to become pregnant, think about the use of birth control.
  • Keep your bones strong. Eating a diet rich in calcium. Do weight-bearing exercises like walking and strength training exercises to the upper part of your body. And don't smoke. Ask your health care team if you need calcium and vitamin D.
  • Keep track of your menstrual cycle. If you miss a period, while the hormone therapy that causes you to have a monthly cycle, get a pregnancy test.

Coping and support

If you hoped for a future pregnancy, you may feel a deep sense of loss after knowing that you have primary ovarian failure. This feeling can happen even if you have already given birth. See a counselor for therapy if you feel that might help you cope.

  • Be open with your partner. Talk with and listen to your partner. Share your feelings about this sudden change in your plans for the growth of your family.
  • Explore your options. If you don't have kids and you want them to, or if you want to have children, look into other ways of expanding your family. You might think about the options such as in vitro fertilization with donor eggs or adoption.
  • Get support. This can help to talk with others who are going through a similar problem. You can get information and understanding during a time of confusion and doubt. Ask a member of your health care team about the national or local support groups. Or look for an online community, as an outlet for her feelings, and a source of information. Also think about how to obtain the advice of a therapist. It can help you adapt to your new circumstances and what that might mean for their future.
  • Give yourself time. It may take a while to come to terms with the fact that they have primary ovarian failure. In the meantime, take good care of yourself. Eat well, exercise and get enough rest.

Preparing for your appointment

Your first visit will probably be with your primary care professional or a gynecologist. If you are looking for a treatment for infertility, you may be referred to a specialist in reproductive hormones and fertility improvement. This is a doctor called a reproductive endocrinologist.

What you can do

When you make the appointment, ask if there is something that you need to do beforehand. For example, you may need to stop eating for a number of hours before you have a certain test. This is called fasting.

Also make a list of:

  • Their symptoms. Include any of the periods, and how long you've been missing them.
  • Key of the personal information. Make a note of the tensions that are most important, recent life changes and your family medical history.
  • Your health history. It is key to include your reproductive history. This can include information about your birth control use, and any pregnancy or breastfeeding. Also note that any past surgeries in the ovaries and at any time, you may have been exposed to chemicals or radiation.
  • All medications, vitamins or supplements that you take. Include the amount you take, also called the dose.
  • Questions to ask your health care team.

Have a family member or friend if you can. This person can help you to remember all information that your health care team gives you.

For primary ovarian failure, some questions to ask your health care professional include:

  • What is the most likely cause of my irregular periods?
  • What other causes could there be?
  • What tests do I need?
  • What treatments are available? What side effects can I expect?
  • How these treatments affect my sexuality?
  • What do you think is the best course of action for me?
  • I have other health conditions. How can I best manage them together?
  • You should see a specialist?
  • Do you have printed material I can have? What sites do you recommend?

Feel free to ask questions as they occur during your appointment.

What to expect from your provider

Your healthcare provider is likely to ask questions, such as:

  • When did you start missing periods?
  • Do you have hot flashes, vaginal dryness or other symptoms similar to those of menopause? For how long?
  • Has had ovarian surgery?
  • Has received treatment for cancer?
  • Do you or any of your relatives have systemic or autoimmune diseases, such as hypothyroidism or lupus?
  • Do any of your family members have primary ovarian failure?
  • How to distressed make your symptoms make you feel?
  • Do you feel depressed?
  • You have had problems in previous pregnancies?
Symptoms and treatment of Primary ovarian insufficiency