Premature Ovarian Failure
I'm Too Young For This!
There is a time of life for women where they expect to have irregular periods, stop menstruating, and stop producing eggs, so the possibility of pregnancy is a thing of the past. That point in time is known as menopause and normally it arrives when a woman is in her early 50s. The loss of ovarian function at this stage is accepted as normal. However, there are millions of young women who are experiencing the signs of menopause who are in their prime, planning families they may never have. One in 1,000 young women between the ages of 15-29 and 1 in every 100 women between the ages of 30-39 are affected by premature menopause, known as premature ovarian failure (POF). POF can strike at any time in a woman's life and whenever it hits, it's devastating.
How Ovulation Works
When a woman under the age of 40 experiences the loss of regular, monthly ovarian function (does not ovulate) she is usually diagnosed with POF. The loss of function can be the result of too few follicles or a dysfunction of the ovaries. By understanding ovulation, it is easier to understand ovarian failure. At the beginning of the menstrual cycle the levels of estrogen are low. The hypothalamus, which is the gland that regulates hormone levels, signals the pituitary gland to send out follicle stimulating hormone (FSH) which has the job of triggering follicles in the ovaries to mature into eggs. Only one of the follicles in the ovaries will actually arrive at maturation. It is the mature follicles that send out the estrogen hormones which signal the hypothalamus to stop producing FSH. If the follicles do not mature, the signal to stop the production of FSH is not received and the result is an overproduction of the hormone. Women with POF are checked for high levels of FSH. The hypothalamus and pituitary glands know by the levels of estrogen that an egg is mature. At this time lutenizing hormone (LH) is released - known as the LH surge - and within 24 to 36 hours, the egg is released from the ovary, ready to be fertilized. Progesterone has been working hard all this time at thickening and preparing the uterus for the implantation of a fertilized egg. If that doesn't happen, the egg dissolves, hormone levels drop, and the lining of the uterus is sloughed off. This process is called menstruation and the whole process starts again.
The Symptoms of POF
Unlike a woman who is menopausal, a woman with premature ovarian failure may still have follicles, however, they may be depleted or dysfunctional, meaning that she can still have a menstrual period but it will likely be irregular. Irregular periods is another sign of POF, as is high levels of FSH. There are other reasons for irregular periods so it is best to be checked by the doctor for a correct diagnosis. The symptoms of POF are virtually the same as they are for menopause: irregular periods, hot flashes, night sweats, low libido, irritability, painful sex and thinning and drying of the vagina. Some women do have regular periods and the only way they know they have POF is through a check of the hormonal levels and an inability to conceive.
Pregnancy is Possible
If a woman has POF and wants to pursue having children, she has options for conception that include donor eggs and fertility treatments. The fertility treatments may involve gonadotropin-releasing hormone (GnRH), estradiol and corticosteroids such as prednisone, Clomid, human menopausal gonadotropins (hMG) or Danazol. Hormone replacement therapy has worked for some women although none of the treatments are guaranteed to restore fertility.