Facing a diagnosis related to your sexual and reproductive health may bring up a lot of concerns. If you're learning about primary ovarian insufficiency causes, symptoms, and treatment for the first time, then it's perfectly natural to have plenty of questions. Here's what you need to know about primary ovarian insufficiency (sometimes known as premature ovarian failure), a condition that is not always talked about.
When a person's ovaries stop working regularly before the age of 40, it's known as primary ovarian insufficiency, according to the Mayo Clinic. "Typical symptoms mimic menopause but is found in women at a younger age," Tamika K. Cross, MD, board-certified obstetrician and gynecologist, tells Romper via email. These symptoms can include hot flashes, decreased libido, vaginal dryness, mood swings, bone loss/osteoporosis, irregular periods, and the eventual loss of periods altogether, Dr. Cross further explains. This final symptom is definitely worth consulting your doctor, because it can signal potential fertility issues. "The most important symptom is the absence of menses without another cause, such as pregnancy. Sometimes, there is some bleeding from the vagina, but it is infrequent or much lighter than what the patient’s period used to be," Carla Lupi, MD, Associate Dean for Assessment and Evaluation at the Kaiser Permanente Bernard J. Tyson School of Medicine, tells Romper in an email.
Affecting approximately one percent of the female population, premature ovarian insufficiency (POI) can occur at nearly any time in life prior to typical menopause, according to the American Society for Reproductive Medicine. It sometimes affects people who are still in their teens as well.
No one is at fault for experiencing premature ovarian insufficiency, because the causes are largely beyond an individual's control. For instance, causes for POI can include exposure to chemotherapy, genetic disorders, autoimmune diseases, and (in rare cases) viruses such as the mumps, explains Dr. Cross. Smoking and radiation therapy are other potential causes of POI, and quitting smoking is one of the few potential risk factors that is under the individual's control, as Dr. Lupi explains.
Family history can be a possible indicator as well. "Genetics do play a role. Women whose mother went through POF at a young age are more likely to follow in the same footsteps but not necessarily," says Dr. Cross. In fact, your mother's age of menopause is one of the things everyone should know about their family's health history, according to Bustle.
Treatment for premature ovarian insufficiency is definitely available, although the exact type of medical care a person receives may depend on the cause of their POI. "For those facing cancer treatments, discussions with their oncologists about the effects of therapies on their ovaries and approaches to minimizing the chance of damage is important," says Dr. Lupi. "Fortunately, the field of fertility preservation techniques for those who want to keep the option of childbearing after therapy have evolved significantly in recent years." If interested, you can discuss options with a fertility specialist before starting cancer therapies.
For those who experience POI because of chromosomal abnormalities or autoimmune issues, many potential treatments are also available. "Hormone therapy for symptom relief, as well as support of bone, cardiovascular and sexual health is the mainstay here," says Dr. Lupi. "This includes some form, such as by mouth or skin patch, of daily estrogen, and then progesterone, which can be delivered through an IUD – a device placed in the uterus, or by mouth." Hormone therapy has been effective at promoting bone density in people experiencing traditional menopause. Discuss your fertility plans with your physician as well, and choose a form of birth control if you're not looking to get pregnant right away.
Lastly, acknowledging the emotional impact of a POI diagnosis is a crucial part of the treatment plan. "POI is a life-altering diagnosis for many women. It brings a diagnosis of reduced fertility that can lead to profound grief for different reasons," says Dr. Lupi. "Concerns about sexual function and health that can negatively affect self-image also result in lowered self-esteem and sadness." Definitely make time for your emotional health throughout treatment as well, and don't hesitate to seek counseling or other support. A premature ovarian insufficiency diagnosis may sound concerning, but treatment and support is definitely available.
Tamika K. Cross, MD, board-certified Obstetrician and Gynecologist
Carla Lupi, MD, Associate Dean for Assessment and Evaluation at the Kaiser Permanente Bernard J. Tyson School of Medicine