What is premature ovarian failure?
Premature ovarian failure is sometimes confused with premature menopause, but there is a basic technical difference.
With premature ovarian failure, periods could be irregular, occurring just occasionally for several years.
With premature menopause, ovulation stops altogether. The critical implication here is that with primary ovarian insufficiency, there is still a chance for a woman to become naturally pregnant, although the odds are certainly diminished.
Premature ovarian failure is also commonly known as primary ovarian insufficiency, or early ovarian failure.
Understanding primary ovarian insufficiency
Primary ovarian insufficiency is a condition wherein the ovaries cease to function optimally prior to middle age or perimenopausal age. Ovarian insufficiency before the age of 40 is generally considered premature. The condition is seen in approximately 1% of women before age 40.
Premature ovarian failure is the cessation of proper hormone production or the inability to ovulate monthly, a condition that contributes to suboptimal fertility or infertility
What ovarian function normally looks like
Normal ovarian function is characterized by a regular monthly cycle of egg production and release (ovulation) and the secretion of estrogen and progesterone, which regulate the menstrual cycle, support reproductive health, and maintain overall bodily function.
Causes of premature ovarian failure
Though there are several direct causes and risk factors for primary ovarian insufficiency, an estimated 90% of spontaneous premature ovarian failure cases do not have a medically identifiable cause.
While identifying what has caused a woman to experience premature ovarian failure is not always possible, there are some potential contributing issues you should discuss with your doctor.
Early ovarian failure explained
The most common causes of primary ovarian insufficiency include the following conditions:
- Genetic and chromosomal causes: Primary ovarian insufficiency sometimes occurs in people with altered, missing, or fragile X chromosomes, such as people with mosaic Turner syndrome or fragile X syndrome.
- Autoimmune disorders: Several autoimmune disorders are linked to primary ovarian insufficiency, including thyroid diseases, type 1 diabetes, lupus, and Addison’s disease.
- Medical treatments: Cancer treatments like chemotherapy and radiation therapy can interfere with cellular function and trigger primary ovarian insufficiency.
Other primary insufficiency risk factors include exposure to chemical environmental toxins, exposure to pesticides, certain viral infections, chronic stress, and smoking.
Signs of premature ovarian failure
Primary premature ovarian failure criteria include being under 40 years of age and experiencing menstrual irregularities (oligomenorrhea) or total cessation of menstruation (amenorrhea).
Premature ovarian failure symptoms include the following:
- Irregular periods, including skipped periods
- Difficulty conceiving
- Night sweats
- Hot flashes
- Vaginal dryness
- Difficulty concentrating
- Lower sex drive
Diagnosis
Several tests and a physical, including a pelvic exam, could be required to diagnose premature ovarian failure. It is recommended that you discuss your options with a physician.
Diagnostic criteria for premature ovarian failure
Diagnosing primary ovarian insufficiency involves conducting a physical exam, undergoing blood tests for follicle-stimulating hormone and estrogen levels, and taking a detailed medical history for related or contributing conditions.
Tests used to confirm POF
When premature ovarian failure is suspected the following tests might be recommended:
- Ovarian ultrasound
- Genetic testing for chromosome anomalies
- Bone density test
Premature ovarian failure and fertility impact
Unlike premature menopause, where ovarian function stops completely, premature ovarian failure involves unpredictable and intermittent ovarian activity. The condition impacts fertility by reducing egg supply and healthy ovarian function.
However, assisted reproductive technology can help achieve pregnancy even when ovarian function is compromised.
Options for preserving fertility
Fertility preservation options for those struggling with primary ovarian insufficiency include the cryopreservation (freezing and storage) of reproductive material. Cryopreservation techniques include the following procedures:
- Embryo freezing: Eggs are retrieved, fertilized with partner or donor sperm via in vitro fertilization (IVF), and the resulting embryos are frozen and stored. This technique is a highly effective and well-established method with high success rates.
- Egg freezing: Unfertilized eggs are retrieved after ovarian stimulation with hormones, and then frozen and stored.
The best option depends on age, medical condition, and personal preferences.
Treatment options for premature ovarian failure
Primary ovarian insufficiency treatments typically focus on symptom management, addressing any long-term health complications from estrogen deficiency, and reestablishing reproductive health.
Premature ovarian failure hormone therapy
Hormone replacement therapy helps to relieve low estrogen symptoms like hot flashes, vaginal dryness, and mood fluctuations. Long-term, hormone replacement therapy might reduce the risk of osteoporosis.
Premature ovarian failure supplements
The most widely recommended supplements are calcium and vitamin D to manage long-term health risks, particularly osteoporosis.
Natural and lifestyle-based approaches
There is no proven natural or lifestyle intervention to restore normal ovarian function in women with premature ovarian insufficiency. However, the following lifestyle modifications can support overall reproductive health:
- A balanced diet: Reducing intake of processed foods, excessive sugar, alcohol, and caffeine can improve hormonal balance and reduce symptoms.
- Regular exercise: Engage in regular, moderate physical activity, especially weight-bearing exercises like walking, jogging, and weight resistance training. These activities help maintain bone health and muscle strength.
- Smoking cessation: Smoking is linked to earlier menopause onset and a host of health problems. Quitting is a vital step for overall health.
- Adequate sleep: Prioritize good sleep hygiene, as sufficient rest supports hormone regulation and general health.
Early menopause vs. premature ovarian failure
Primary ovarian insufficiency and early menopause are distinct conditions, with the core difference being the age of onset and the nature of ovarian function.
Premature ovarian failure is a condition where ovarian function is compromised before age 40, whereas early menopause is the complete and permanent cessation of ovarian function between ages 40 and 45.
Despite the differences, both early menopause and premature ovarian failure involve the earlier-than-typical loss of ovarian hormones and share similar symptoms, which is why they are often confused.
When to see a doctor
If you miss your period for three months, it is advised to see a physician or premature ovarian failure specialist to find out why. Among other complications, loss of ovarian function could be a sign of low estrogen levels, which can lead to bone loss.
Personalized fertility care in California
At Pacific Reproductive Center, we offer targeted therapies and assisted reproductive technologies like in vitro fertilization (IVF), donor egg programs, and tailored solutions to help individuals and couples achieve their dream of parenthood.
By combining cutting-edge medical expertise with compassionate care, Pacific Reproductive Center offers hope and support to those seeking to build beautiful families. Please contact our helpful representatives to schedule a consultation today at a location near you.
Frequently asked questions
Can premature ovarian failure happen suddenly?
Yes, premature ovarian failure can happen suddenly. For some women, menstruation stops abruptly without accompanying symptoms or irregularities. The change may be particularly noticeable after stopping birth control pills or after a pregnancy, when periods fail to resume.
Can POF be temporary in some women?
Yes, premature ovarian failure can be temporary in some rare circumstances, but the majority of cases where the causal factor is not known are typically considered permanent.
Does POF always lead to infertility?
Premature ovarian failure does not always lead to permanent inability to achieve pregnancy; there can be intermittent ovarian function leading to spontaneous pregnancy.
To determine if your symptoms are due to primary ovarian insufficiency rather than early menopause or a potential reproductive health complication, you need a medical evaluation from a healthcare provider.
Can diet or supplements improve ovarian function?
While many women and couples seek solutions for how to reverse premature ovarian function naturally, there is no definitive evidence that dietary changes or supplements restore normal ovarian function in people with diagnosed premature ovarian failure.
However, diet and supplements can offer benefits like supporting bone health and minimizing uncomfortable symptoms.
Is pregnancy possible after a POF diagnosis?
Yes, pregnancy is possible after being diagnosed with primary ovarian insufficiency, though such occurrences are rare, with a probability of about 5%.
