Premature Ovarian Failure (POF)

Premature ovarian failure (POF) is a condition that affects women before the age of 40 when their ovaries stop functioning normally.

Premature Ovarian Failure (POF): What You Need to Know

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Premature ovarian failure (POF) is a condition that affects women before the age of 40 when their ovaries stop functioning normally. This means that they produce less oestrogen and release fewer eggs, which can lead to infertility and other health problems.

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Causes Of POF

The causes of POF are not fully understood, but some possible factors include:

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  • Genetic or chromosomal abnormalities, such as Turner syndrome or Fragile X syndrome, affect the development or function of the ovaries.
  • Autoimmune disorders, such as thyroid disease or Addison's disease, that cause the body's immune system to attack the ovaries.
  • Infections, such as mumps or tuberculosis, that damage the ovarian tissue.
  • Toxins, such as chemotherapy or radiation therapy, that destroy the ovarian cells.

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Symptoms Of POF

The symptoms of POF are similar to those of menopause or low oestrogen levels, such as:

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  • Irregular or missed periods
  • Hot flashes and night sweats
  • Vaginal dryness and atrophy
  • Mood changes and cognitive difficulties
  • Decreased sexual desire and function
  • Osteoporosis and cardiovascular disease

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Diagnosis Of POF

The diagnosis of POF is based on:

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  • A history of menstrual irregularities or infertility
  • A blood test that measures the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH). High FSH and LH levels and low estradiol and AMH levels indicate ovarian insufficiency.
  • A transvaginal ultrasound shows the size and appearance of the ovaries. Small ovaries with few follicles suggest ovarian failure.
  • A karyotype test that analyses the chromosomes for any abnormalities.
  • Other tests that screen for underlying medical conditions, such as thyroid function tests, prolactin level, adrenal function tests, and bone density scans.

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Treatment Of POF

The treatment of POF aims to:

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  • Restore oestrogen levels and prevent complications, such as osteoporosis and cardiovascular disease. Hormone replacement therapy (HRT) is the main option for this purpose. It involves taking oestrogen and progesterone pills, patches, or creams to mimic the natural hormonal cycle. HRT can also relieve some of the symptoms of POF, such as hot flashes and vaginal dryness.
  • Preserve fertility and achieve pregnancy, if desired. Although POF usually results in infertility, some women may still have occasional ovulation and spontaneous pregnancy. However, this is rare and unpredictable. Therefore, other options for having a child include using donor eggs, donor embryos, or adoption.
  • Provide psychological support and counselling. POF can have a significant impact on a woman's emotional well-being, self-esteem, and quality of life. It can also affect her relationships with her partner, family, and friends. Therefore, it is important to seek professional help or join a support group to cope with the emotional aspects of POF.

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Sources:

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[1] Primary ovarian insufficiency - Symptoms and causes - Mayo Clinic https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683

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[2] Premature ovarian failure - Symptoms, diagnosis, and treatment | BMJ Best Practice US https://bestpractice.bmj.com/topics/en-us/1004

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[3] Primary Ovarian Insufficiency | Endocrine Society https://www.endocrine.org/patient-engagement/endocrine-library/primary-ovarian-insuffiency

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[4] Premature Ovarian Failure | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic https://academic.oup.com/jcem/article/93/2/E2/2825432