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Primary Ovarian Insufficiency: Causes, Symptoms, and Management

Primary Ovarian Insufficiency?

Primary Ovarian Insufficiency (POI) is also known as premature ovarian failure. It occurs due to the dysfunction of ovarian follicles which results in the termination of menses before the age of 40 in women. If ovaries fail, they do not produce a normal amount of hormones (estrogen) and also do not release the eggs. It is sometimes referred to as premature menopause, but it is generally not the same. In Primary Ovarian Insufficiency, women may experience irregular periods or occasional periods for years or might even get pregnant. But in premature menopause, women may no longer have periods and cannot conceive. However, Primary Ovarian Insufficiency helps the people affected by it, to prevent a few complications. One example of such is osteoporosis (a condition in which bones become brittle or weak).

Etiology

Primary Ovarian Insufficiency occurs due to many reasons; some of them include:

1.Chromosomal Abnormality:

The primary cause of Primary Ovarian Insufficiency is gonadal dysgenesis (congenital development disorder of the reproductive system), with or without Turner syndrome.

2.Chemo or Radiation Therapy:

Primary Ovarian Insufficiency may occur in a few people after the exposure to chemotherapy or radiation therapy – which is termed as acute ovarian failure.

3.Fragile X Syndrome:

It is an inherited condition characterized by damaged X chromosomes especially due to folic acid deficiency – thus results in POI.

Signs and Symptoms:

1) Irregular or missed periods
2) Difficulty in conceiving
3) Hot flashes
4) Night sweats
5) Vaginal dryness
6) Irritability or inability to concentrate
7) Decreased sexual desire 

Risk Factors:

Below are the conditions that may develop Primary Ovarian Insufficiency:

1. Age:

One of the main reasons among individuals to develop POI at the age of 35-40.

2.Hereditary:

Family history of Primary Ovarian Insufficiency may increase the risk of POI.

3.Multiple Ovarian Surgeries:

Surgeries related to ovaries may increase the risk of POI.

Complications Include:

1.Infertility: Women may not conceive.

2.Osteoporosis: Estrogen is helpful to maintain strong bones, but people with POI may experience low levels of estrogen and the bones may become weak and brittle.

3.Depression or anxiety: The risk of infertility may lead to depression or anxiety.

4.Heart disease: Low levels of estrogen might increase heart diseases.

5.Dementia: Lack of estrogen contributes to dementia.

Diagnosis:

Diagnosis will be done by a doctor which includes:

1.Medical History

2.Pregnancy test

3.Physical examination

4.Blood test

5.Pelvic ultrasound

Treatment:

There is no complete cure available currently. However, there is treatment available which targets the symptoms, from this, there are chances to lower the complications:

1.Hormone Replacement Therapy: It is the most commonly used treatment by compensating the hormones that the ovaries failed to do.

2.Supplements: Women with POI are at a higher risk of developing osteoporosis; therefore, calcium and vitamin supplements should be given daily.

3.Regular exercise: Controlling weight and regular exercise may help to reduce the risk of osteoporosis and heart diseases.

4.Treatment for Associated Conditions: If any condition that contributes to the sign of POI, it must be treated by medicines/hormones.

Written by MedPlus