Ageing is regarded as one of the main causes of female infertility, but certain reproductive issues deprive women much younger of their ability to give birth. One of these issues is premature ovarian insufficiency, also known a primary ovarian insufficiency. As the name suggests, the condition is characterised by the ovaries losing their functionality before time; the ovaries stop the release of eggs even before a woman turns 40 and she is likely to come across grave complications including female infertility.
It is important to realise that premature ovarian insufficiency is different from menopause, though much is similar between the two and this is the reason that women consider them one and the same. Therefore, it becomes imperative to understand what premature ovarian insufficiency actually is and know all about is causes, symptoms and treatment.
What is premature ovarian insufficiency?
When a woman’s ovaries stop functioning normally before the age of 40 years, she is said to be suffering from premature ovarian insufficiency. The ovaries fail to release the eggs regularly as well as there is disruption in production of estrogen, the key female hormone. One in every 100 women comes across the condition, which directly influences her ability to conceive, though there are options if she wants to get pregnant.
Normally, menopause is the milestone when ovarian failure takes place in women, as the ovaries are depleted naturally of their supply of eggs and the estrogen levels decline too. This happens at the age of 50 years on the average, but when women start experiencing these symptoms much earlier, they are said to be suffering from premature ovarian insufficiency. They are likely to have irregular periods and even missed periods for several months, while the periods stop altogether for those who have menopause.
Causes of Premature Ovarian Insufficiency
The loss of functioning of ovaries can be attributed to various causes, which may or may not be detected easily. Here are some of them:
- Genetic defects: In some women, genetic disorders such as Turner’s syndrome may be the reason of premature ovarian failure. Women suffering from this syndrome have one normal X chromosome while the second is an altered one. The fragile X syndrome is another chromosomal defect whereby the X chromosomes are fragile and can break easily.
- Autoimmune disease: The woman may be suffering from a rare autoimmune disease, in which the immune system synthesizes such antibodies which damage the ovarian tissues and harm the eggs and follicles.
- Exposure to toxins: Women with the history of chemotherapy and radiation treatment may suffer from ovarian failure because of exposure to toxins. Similarly, the toxins in cigarette smoke, pesticides and chemicals can deprive the ovaries from their ability to produce follicles.
Besides these causes of premature ovarian insufficiency, the exact reason may not be detected in some cases and further investigations may be required to establish the cause. The risk is higher for women with a family history of premature ovarian failure and those who have undergone multiple ovarian surgeries (for treatment of ovarian endometriosis or some other conditions).
Symptoms and Diagnosis of Premature Ovarian Insufficiency
Irregular or skipped periods make the main symptom of premature ovarian insufficiency, while there are other menopause-like symptoms too. These include estrogen deficiency, night sweats, hot flashes, vaginal dryness, loss of sex drive and irritability. The woman may have her periods on and off, which makes it difficult to conceive if she plans a pregnancy. The similarity to menopause symptoms might confuse the woman and she needs to go for proper medical diagnosis to verify her condition.
When a woman comes across irregularity of menstrual periods and premature ovarian insufficiency is suspected, the doctor will start with a physical exam and a pregnancy test to rule out the same. Further, blood tests are conducted to check out the level of follicle stimulating hormone (FSH), which goes unusually high for women suffering from premature ovarian failure. The estradiol test is another one to detect the levels of estrogen in the bloodstream; lower than normal level indicates ovarian insufficiency. The doctor may recommend a transvaginal ultrasound scan to evaluate the size of ovaries.
Complications of Premature Ovarian Insufficiency
Women suffering from the condition can come across the following complications:
- Female infertility: When the ovaries stop producing eggs effectively, there is a direct influence on the ability to conceive. However, some women do get pregnant with the right treatment.
- Osteoporosis: Estrogen plays a key role in maintaining bone health in females. Those who come across ovarian failure before time develop a high risk of osteoporosis or bone loss as the levels of estrogen drop due to malfunctioning ovaries.
- Other complications: Lower levels of estrogen also make a woman susceptible to an array of health issues such as increased risk of heart disease, depression and dementia.
Treatment of Premature Ovarian Insufficiency
Till date, there is no proven treatment of the condition, though researchers are working towards managing it in the most effective manner. Primarily, doctors work on normalizing the estrogen levels by relying on hormone replacement therapy to curb the risk of complications such as osteoporosis, hot flashes, heart problems and depression. The issue is grave for women who plan pregnancy because premature ovarian insufficiency can compromise with their fertility. Such women may have to explore options such as donor eggs and IVF to become pregnant.
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