Primary ovarian insufficiency — also called premature ovarian failure — occurs when the ovaries stop functioning normally before age 40. When this happens, your ovaries don’t produce normal amounts of the hormone estrogen or release eggs regularly. This condition often leads to infertility.
Primary ovarian insufficiency is sometimes confused with premature menopause, but these conditions aren’t the same. Women with primary ovarian insufficiency can have irregular or occasional periods for years and might even get pregnant. But women with premature menopause stop having periods and can’t become pregnant.
Restoring estrogen levels in women with primary ovarian insufficiency helps prevent some complications that occur as a result of low estrogen, such as osteoporosis.
What causes premature ovarian failure?
Sometimes it is not possible to identify a reason why this condition has occurred. However, some identified causes may include:
genetic problems, such as Turner syndrome, autoimmune diseases where the body does not recognize certain tissues and attacks itself; for example, lupus, the side effects of chemotherapy, radiotherapy, and other cancer treatments, and a number of general conditions, such as enzyme deficiencies or infections like mumps.
What symptoms manifest in relation to this disorder?
Signs and symptoms of primary ovarian insufficiency are similar to those of menopause or estrogen deficiency. They include:
- Irregular or skipped periods, which might be present for years or develop after a pregnancy or after stopping birth control pills.
- Difficulty getting pregnant.
- Hot flashes.
- Night sweats.
- Vaginal dryness.
- Dry eyes.
- Irritability or difficulty concentrating.
- Decreased sexual desire.
How common is premature ovarian failure?
It is relatively rare, occurring in one in 1,000 women under the age of 30 and one in 100 women under the age of 40.
Is premature ovarian failure inherited?
Most cases of premature ovarian failure are not inherited. Approximately 10% of patients have a family history of the condition.
When to see a doctor
If you’ve missed your period for three months or more, see your doctor to determine the cause. You can miss your period for a number of reasons — including pregnancy, stress, or a change in diet or exercise habits — but it’s best to get evaluated whenever your menstrual cycle changes.
Even if you don’t mind not having periods, it’s advisable to see your doctor to find out what’s causing the change. Low estrogen levels can lead to bone loss and an increased risk of heart disease.
Complications
The complications of primary ovarian insufficiency include:
Infertility: The inability to get pregnant can be a complication of primary ovarian insufficiency. In rare cases, pregnancy is possible until the eggs are depleted.
Osteoporosis: The hormone estrogen helps maintain strong bones. Women with low levels of estrogen have an increased risk of developing weak and brittle bones (osteoporosis), which are more likely to break than healthy bones.
Depression or anxiety: The risk of infertility and other complications arising from low estrogen levels causes some women to become depressed or anxious.
Heart Disease: Early loss of estrogen might increase your risk.
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