Premature Ovarian Failure (POF)

Premature Ovarian Failure: Causes, Symptoms & Treatment

Premature Ovarian Failure is the loss of normal function of one’s ovaries prior to the age of 40. Sometimes referred to as premature ovarian insufficiency or early menopause it is usually characterized by amenorrhea (loss of one’s menstrual period), hypoestrogenism (estrogen deficiency) as well as elevated serum gonadotropin (FSH – Follicle Stimulating Hormone and LH – Luteinizing Hormone) levels.

Causes Of Premature Ovarian Failure

Premature ovarian failure can be caused by exposure to certain chemicals, chemotherapy and radiation for cancer treatment. It can also result from other conditions that can affect cycle-regulating hormones or damage the ovaries so they no longer produce eggs. Certain genetic disorders can trigger premature ovarian failure, as can autoimmune diseases – such as lupus or rheumatoid arthritis – that cause the body to mistakenly attack the ovaries.  If your mother experienced premature ovarian failure, you are at increased risk to experience it yourself.  However, most women with premature ovarian failure have no family history of this condition and no risk factors.

Symptoms Of POF

Many women, particularly at the early stages of POF, have no symptoms to report. Some signs or symptoms of premature ovarian failure may include irregular or skipped menstrual periods. You may experience hot flashes, night sweats and vaginal dryness. If you experience more than 3 consecutive months of skipped periods and are seeking to become pregnant or if you have any combination of the above symptoms the best thing is to see a Reproductive Endocrinologist to determine what your options are for trying to conceive. They may consist of IVF with your own eggs or doing a Donor-Assisted IVF cycle.

POF Treatment

If pregnancy is desired there is no specific treatment protocol for POF. There is no treatment at this time to restore one’s ovarian reserve. The only treatments are to potentially reduce the side effects of POF such as:

Estrogen Therapy

  • Estrogen therapy can help prevent osteoporosis and relieve hot flashes and other symptoms of estrogen deficiency. Your doctor typically prescribes estrogen with the hormone progesterone, especially if you still have your uterus. Adding progesterone protects the lining of your uterus (endometrium) from precancerous changes caused by taking estrogen alone.
  • The combination of hormones can cause vaginal bleeding again, but it won’t restore ovarian function. Depending on your health and preference, you might take hormone therapy until around age 50 or 51 — the average age of natural menopause.
  • In older women, long-term estrogen plus progestin therapy has been linked to an increased risk of heart and blood vessel (cardiovascular) disease and breast cancer. In young women with premature ovarian failure, however, the benefits of hormone therapy outweigh the potential risks.

Calcium And Vitamin D Supplements

  • Both are important for preventing osteoporosis, and you might not get enough in your diet or from exposure to sunlight. Your doctor might suggest bone density testing before starting supplements to get a baseline bone density measurement.
  • For women ages 19 through 50, the Institute of Medicine recommends 1,000 milligrams (mg) of calcium a day through food or supplements, increasing to 1,200 mg a day for women age 51 and older.
  • Scientists don’t yet know the optimal daily dose of vitamin D. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. If your blood levels of vitamin D are low, your doctor might suggest higher doses.
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