Premature Ovarian Failure (POF) is the cessation of ovarian activity before the age of 40. Depending on its origin, it can be divided in to:

  • Iatrogenic: Secondary to cancer treatment (radiation or chemotherapy), surgeries that have totally or partially removed the ovaries.
  • Chromosomal or Genetic: The most common are Turner syndrome and fragile X syndrome.
  • Autoimmune: The immune system creates antibodies accelerating the loss of eggs, including autoimmune disorders which are frequently associated with FOP are thyroid diseases and adrenal gland diseases.
  • Lifestyle and environmental factors: The most commonly used and proven factors are tabacco, pesticides and solvents.

Sadly in most cases the cause is unknown.

The percentage is of 1% in under 40s and 1/00 before 3 years. The risk of PFO increases if there is direct family history.

Premature ovarian failure symptoms

Symptoms presented by these patients and the reason for them consulting their gynecologist, are:

  • lack of menstruation (the main reason for consultation)
  • Irregular or skipped periods (amenorrhea)
  • hot flushes
  • decreased libido
  • vaginal dryness
  • Irritability or difficulty concentrating

If you notice that you’ve skipped your period for three months or more, see your gynecologist to determine what may be the cause. At IMED Hospitals, through the Levante Institute of Gynaecology, is specialised in carrying out tests for the diagnosis and treatment of premature ovatian failure. You can know more about this Gynaecology Unit here.

Premature ovarian failure diagnosis

The diagnosis is based on a careful medical history examination, which insists on the existence of relatives diagnosed with FOP. A physical and gynecological examination will be made and a your doctor may also recommend one or more of these tests:

  • Pregnancy test: It checks for the possibility of an unexpected pregnancy in a woman.
  • Follicle-stimulating hormone (FSH) test: Women with premature ovarian failure often have abnormally high levels of FSH in the blood.
  • Blood test. A blood test must include Estradiol test (low level of estradiol is usual in women with premature ovarian failure) and Prolactin test (high levels of prolactin can lead to problems with ovulation).
  • Karyotype test. This is a test that examines all 46 of your chromosomes for abnormalities.
  • FMR1 gene test. The FMR1 gene is the gene associated with fragile X syndrome.

Premature ovarian failure treatment

Your gynecologist may recommend some of this treatments:

  • Estrogen therapy. This treatment is recommended to compensate for the estrogen your ovaries no longer produce. So, it helps prevent osteoporosis and relieve hot flashes and other symptoms of estrogen deficiency.
  • Calcium and vitamin D supplements. Your doctor may suggest supplements for preventing osteoporosis.

Secondary to the cessation of ovulation, infertility problems appear. In cases with unknown etiology, spontaneous pregnancies between 5-10% may be acheived due to possible, occasional ovulations. Unfortunately there is no way to tell if this will happen. In these cases, treatments that stimulate ovulation are not useful, so appropriate treatment would be to use egg donation.