Spontaneous premature ovarian failure occurs when the ovaries cease their function before the age of forty. Once this occurs, the ovaries are not producing the normal amounts of estrogen or releasing eggs regularly. Diagnosing this condition and beginning treatment can help to prevent further complications that occur due to low levels of estrogen, like osteoporosis.
Primary ovarian insufficiency is often confused with premature menopause, but they are not the same. Those with primary ovarian insufficiency can and still have regular or occasional periods for years, and they still can get pregnant. Those menstruators facing premature menopause stop having periods and cannot become pregnant.
Symptoms of Spontaneous Premature Ovarian Failure
These symptoms are very similar to those of menopause or estrogen deficiency, and can include:
- Hot flashes
- Skipped or irregular periods
- Infertility issues
- Night sweats
- Vaginal dryness
- Dry Eyes
- Irritability
- Vaginal Atrophy
- Difficulty concentrating
- Loss of libido
If you have missed your period for three months or more, you should schedule an appointment with your medical care team to determine the cause. Periods can be missed for a variety of reasons, so it is best to be evaluated to note these menstrual changes. This still holds true is you do not miss your periods that have vanished- you still need to know what is going on with your body!
Causes of Spontaneous Premature Ovarian Failure
Primary ovarian insufficiency could be caused by:
- Toxins. Chemotherapy, radiation, and some prescription medications have been linked to toxin-induced ovarian failure. The cellular makeup is often damaged with these treatments, leading to these issues. Other environmentally contributing toxins are cigarette smoke, chemicals, pesticides, and certain viruses.
- Chromosome changes. Certain genetic disorders are associated with this condition, such as Turner syndrome, or Fragile X syndrome.
- Immune System Issues. This rare form occurs when the immune system produces antibodies against your own ovarian tissue, harming all parts of the ovaries and function. It is not known what triggers this immune response, but it can happen at any age or time in life.
- Unknown factors. The cause of SPOF is often unknown. Your medical care provider can do certain testing that can help to narrow down the cause, but many are left without specifics.
Risk Factors for Spontaneous Premature Ovarian Failure
There are certain factors that can increase your risk for this condition. These include:
- Ovarian Surgery. Part surgeries involving the ovaries in any way increase the overall risk of SPOF.
- Family history. If another menstruator in your close family tree has any form of ovarian failure, this increases your risk.
- Age. The risk goes up for those between the ages of 35 and 40, although it is incredibly rare for those under 30 to face this condition.
Complications from SPOF
These complications could arise as you deal with spontaneous premature ovarian failure.
- Heart disease. The early loss of estrogen in the body can increase your risk.
- Infertility. The inability to get or maintain a pregnancy can be a complication of POF. In some cases, pregnancy may be possible until the eggs are depleted.
- Osteoporosis. Estrogen helps to maintain strong bones. Those with low levels of estrogen have an increased chance of developing weak or brittle bones.
- Depression or anxiety. The challenges that come from dealing with SPOF alone can cause the person to become depressed, or anxious about the future.
Diagnosis of Spontaneous Premature Ovarian Failure
Most will show a few signs of ovarian insufficiency, but it is often suspected by medical professionals before the patient is even aware. Diagnosis involves a physical exam, including a pelvic exam. You will be asked questions about your menstrual cycle, exposure to toxins and medications, and any previous abdominal or ovarian surgeries. Your doctor may also request tests for:
- Hormone levels. Ordering tests to check the levels of hormones in your blood, including follicle-stimulating hormone (FSH), estrogen (estradiol), and the hormone that stimulates breast milk production (prolactin).
- Pregnancy. It is vital to rule out a pregnancy before moving forward with any treatment.
- Chromosome changes or certain genes. A blood test called a karyotype analysis can look for changes in your chromosomes.
Treatment for Spontaneous Premature Ovarian Failure
Typically, treatment for ovarian insufficiency usually focuses on the problems occurring from the deficiency of estrogen. Your doctor may recommend:
- Calcium and Vitamin D supplements. These nutrients are vital for bone density and immune support. These are also commonly low in many adults around the world. Your doctor can do blood testing to find out your levels, and then guide you to a high-quality supplement that will work for your situation.
- Estrogen therapy. This therapy can help to prevent osteoporosis, relieve hot flashes, and reduce the overall symptom load that comes from low estrogen. Certain uses of estrogen can trigger heart and blood vessel disease, so always check with your doctors before beginning any new treatment.
As with any new treatment, your doctor will discuss the benefits and risks with you at your appointment.
Lifestyle & Home Treatment for SPOF
Understanding your ovarian insufficiency can help you to better work through the challenges that arise. With proper treatment and time for self-care, you can still lead a functional, exciting life.
- Learn about alternatives for having children or growing your family. Because there is no real way to “preserve fertility” in this case, talk to your doctor about in vitro fertilization, using donor eggs, or even adoption.
- Talk with your doctor about the best contraception methods. Some women with spontaneous primary ovarian insufficiency do spontaneously conceive. If you do not want to become pregnant at all, consider learning about your birth control options.
- Keep your bones strong. Eat calcium rich foods and participate in weight bearing exercises like walking or strength training for your upper body. Do not smoke!
- Track your menstrual cycle. If you miss a period while taking hormone therapy, get and take a pregnancy test immediately.
If you suspect that you may have spontaneous premature ovarian failure, or any type of ovarian failure, do not hesitate to contact your medical care provider to schedule an appointment.
Citations:
Centers for Disease Control and Prevention
National Institutes of Health and Human Services
World Health Organization