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Understanding Premature Ovarian Failure and Treatment

| 06 Jun 2020 | 20355 Views |

What is Premature Ovarian Failure?

Premature Ovarian Failure, also known as Primary Ovarian Insufficiency (POI) is a rare condition in which the ovaries of the female stop functioning, i.e. stop producing eggs Pre-Menopause. In this case, the ovaries of the female fail to produce normal amounts of estrogen and release eggs on time.

Premature Ovarian Failure is often confused with a Premature Menopause but their conditions are not the same, in this case, it is possible for a female to get pregnant. This disease can exist from the onset of puberty or even from birth in which the girl never startsthe menstruation cycle.

Premature Ovarian Failure Causes

Ovulation problems have become very common these days but Premature Ovarian Failure is still very rare. There are only about a million cases reported in a year in India.

Some of its causes are:

  • Immune system responses to ovarian tissue (Autoimmune Disease): In this rare disease in which the immune system in the female’s body produces antibodies against its ovarian tissue harm the follicles which contain the egg and damage it.
  • Effect of Toxins: Heavy medications and strong medical treatments like Chemotherapy and radiation therapies have their side effects and they can damage the genetic material in cells and can cause Ovarian Failure. Several other toxins like cigarette smoke, chemicals, pesticides, and viruses contribute to damaging the ovaries.
  • Tuberculosis of the Genital Tract: It is one of the primary causes leading to premature ovarian failure.
  • Resistant Ovaries: It is a type of Ovarian Failure which is a result of functional disturbances in the ovarian follicles.
  • Chromosomal Defects: Genetic disorders are a major cause behind the failure of premature ovarian which can be passed on to generations. This might include mosaic Turner Syndrome in which the X chromosome carried by the woman gets fragile and breaks causing the failure.
  • Unknown Factors: There is several unknown factors that cause Premature Ovarian failure. In this case, the doctors recommend getting further testing done to determine the causes.

Premature Ovarian Failure Risk Factors

Factors that contribute to developing primary ovarian insufficiency lead to failure include:

  • Age: The risk of developing POF goes up in females between the ages of 35 and 40. Although it is rare before age 30, primary ovarian insufficiency is still possible in younger women and even those who are in their pre-teens.
  • Family history: Having a family history of POF increases your risk of having this disorder.
  • Ovarian surgery: Surgeries that involve the ovaries increase the risk of developing POF.

What are the Symptoms that indicate Premature Ovarian Failure?

The premature ovarian failure symptoms are similar to that of Menopause or Estrogen deficiencies and are pretty much self-diagnosable.

The symptoms can be like:

  • Hot flashes
  • Night sweats
  • Difficulty getting pregnant
  • Vaginal dryness
  • Decreased sexual desire
  • Dry eyes
  • Irregular or skipped periods, which might be developed after a pregnancy or after stopping birth control pills or have been there for a long time.
  • Irritability or difficulty concentrating
  • Experiencing pain while having sex
  • Insomnia
  • Mood swings

If one experiences one or several of the above-listed system, if you missed your period for three or more months, it is suggested to consult a doctor as soon as possible. There can be other reasons like pregnancy or stress for missing your period but it can be best evaluated by a doctor.

Diagnosis of Premature Ovarian Failure

The first step in determining Premature Ovarian Failure is the blood test which tells the levels of Estrogen which is produced by Ovaries. The blood test also determines whether the pituitary gland is functioning properly and producing hormones. If the tests indicate increased Pituitary hormones and if the ovary is not releasing estrogen, it is a clear sign or Premature Ovarian Failure.

Another method of determining whether a female is suffering premature ovarian failure is to conduct transvaginal ultrasound which will determine if the female has follicles on her ovaries. The premature ovarian failure diagnosisis a great source that helps patients gets the right treatment on time. It increases the chances of cure.

Risks of having Premature Ovarian Failure

The long-term health risks of Premature Ovarian Failure include infertility, osteoporosis, cardiovascular, and neurologic diseases and might even have an increased risk of premature death.

Females who are diagnosed with POF also show psychological problems including irritability, forgetfulness, insomnia, and poor concentration. Getting diagnosed with POF leaves the female emotionally strained who are known to display symptoms of depression and anxiety which can be categorized as post-traumatic stress disorder.

Treatment of Primary Ovarian Failure

Premature ovarian failure treatment is possible today. India IVF Clinic has its infertility centers at different locations and offers premature ovarian failure treatment with good success rate. To treat Primary Ovarian Failure doctors tend to cure the levels of estrogen, which further boosts the ovary function.

To do so, doctors might suggest any of the following two treatments:

Estrogen therapy

Estrogen therapy can help in preventing osteoporosis as well as provides relief with hot flashes and other symptoms of estrogen deficiency. Doctors typically prescribe estrogen with the hormone progesterone, especially if you have not got your uterus removed. Adding progesterone protects the lining of your uterus from precancerous changes that may be triggered by taking estrogen alone.

The combination of hormones may make your menstrual cycle normal but it doesn’t restore ovarian function. Depending on your health and preferences, you might take hormone therapy until around the age of 50 which is the average age of having natural menopause.

In older women, long-term estrogen plus progestin medication has been observed to increase therisk of heart and blood vessel diseases and even breast cancer. In young women with POF, however, the benefits of hormone therapy outweigh the potential risks.

Calcium and vitamin D supplements

Both nutrients play a very important role in preventing osteoporosis. Most of the time, you might not get enough on them in your diet or from exposure to sunlight so your doctor might suggest bone density testing before starting supplements to get a baseline measurement of the amount needed.

Women in their fertile ages i.e. 19 to 50, generally require 1,000 milligrams of calcium a day through food or supplements which can be increased to 1,200 milligrams a day for women aged 51 and above.

The ideal daily dosage of vitamin D is not yet clear. A good starting point for adults is about 600 to 800 milligrams a day, through food or supplements.

Addressing Premature Ovarian Failure

Ovarian rejuvenation by various modalities of PRP, and lifestyle changes are tried.

Sometimes, there is no treatment proved to restore fertility. All the other health factors can be restored but the egg-producing capacity of ovaries just never comebacks. In these cases, some women and their partners pursue pregnancy through In Vitro Fertilization (IVF) using donor eggs. The procedure involves getting eggs from a donor and fertilizing them with your partner’s sperm in a lab. The fertilized egg (embryo) is then placed in your uterus for further growth.

The timely diagnosis, causes, and treatment of premature ovarian failure help overcome the problem to a great extent. There are many small and big clinics in the country offering premature ovarian failure treatment around the clock. India IVF Clinic is one of the top infertility clinics for the best and most satisfactory treatment for infertility in males and females.

About The Author
Dr. Richika Sahay

MBBS (Gold Medalist), DNB (Obst & Gyne), MNAMS, MRCOG (London-UK), Fellow IVF, Fellow MAS, Infertility (IVF) Specialist & Gynae Laparoscopic surgeon,[Ex AIIMS & Sir Gangaram Hospital, New Delhi]. Read more

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