• Primary Ovarian Failure

    (Primary Ovarian Insufficiency, Premature Menopause)

    Definition

    Primary ovarian failure (POF) is the stoppage of ovaries before menopause has started. Ovaries make certain hormones called estrogen and progesterone that affect many parts of the body. Loss or changes in these hormones can affect the health of the bones, heart, and blood vessels.
    Female Reproductive Organs
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    Causes

    POF is caused by damage or destruction of the ovaries. Common reasons include:
    In some women, the cause may not be known.

    Risk Factors

    Factors that increase your chances of POF include:
    • Cancer treatments, such as chemotherapy and radiation therapy
    • Viral infections, such as mumps, tuberculosis, and malaria

    Symptoms

    Symptoms are similar to those of menopause and may include:
    • Irregular menstrual cycle
    • Hot flashes
    • Night sweats
    • Decreased interest in sex
    • Irritability
    • Difficulty sleeping
    • Vaginal dryness

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam and a pelvic exam may also be done.
    The blood may be tested to look for changes in hormone levels.

    Treatment

    The goal of treatment is to manage any problems caused by the change in hormones. You and your doctor can talk about the best treatment plan for you. Options include:
    • Hormone replacement therapy (HRT) or estrogen/progestogen contraceptive pills—To replace hormones until the age of natural menopause.
    • Vitamin D and calcium supplement—To support bone health and reduce the risk of osteoporosis.
    Infertility is a common problem with POF. In vitro fertilization may be an option for some who wish to have a pregnancy.
    Women who are planning a procedure or treatment with a risk of POF may consider fertility preservation and family planning options before undergoing treatment. One option is to preserve healthy eggs to be used during in vitro at a later date.

    Prevention

    To help reduce your chance of getting POF, women with cancer should discuss cancer treatment options with their doctors.

    RESOURCES

    Resolve http://www.resolve.org

    The American Congress of Obstetricians and Gynaecologists http://www.acog.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    The Society of Obstetricians and Gynecologists of Canada http://sogc.org

    References

    Premature ovarian failure: premature menopause. American Pregnancy Association website. Available at: http://americanpregnancy.org/womens-health/premature-ovarian-failure/. Published August 2015. Accessed August 1, 2016.

    Premature ovarian failure—what do I need to know? Resolve website. Available at: http://www.resolve.org/about-infertility/medical-conditions/premature-ovarian-failure-what-do-i-need-to-know.html. Published Summer 2012. Accessed August 1, 2016.

    Primary ovarian insufficiency (POI). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114914/Primary-ovarian-insufficiency-POI#Overview-and-Recommendations. Updated February 18, 2016. Accessed December 21, 2016.

    Premature ovarian insufficiency. Patient UK website. Available at: http://patient.info/health/premature-ovarian-insufficiency-leaflet. Updated January 19, 2016. Accessed August 1, 2016.

    Primary ovarian insufficiency (POI): overview. National Institute of Child Health and Human Development website. Available at: https://www.nichd.nih.gov/health/topics/poi/Pages/default.aspx. Updated April 12, 2013. Accessed August 1, 2016.

    Primary ovarian insufficiency in adolescents and young women. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Primary-Ovarian-Insufficiency-in-Adolescents-and-Young-Women. Published July 2014. Accessed August 1, 2016.

    Revision Information

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