Premature ovarian failure

Approximately 1 in 1,000 women aged 15 to 29 and 1 in 100 women aged 30 to 39 suffer from premature ovarian failure, also called premature menopause. A woman can experience premature ovarian failure at any age and at any time in her life. This may happen before or after she has children, or while she is still planning her family.

Whatever the season of life is, it is overwhelming and questions often arise that remain unanswered. Here are some of the most frequently asked questions about premature ovarian failure.

What is premature ovarian failure?

Premature ovarian failure is the loss of ovarian function in women under the age of 40. Women with premature ovarian failure do not ovulate (release an egg) every month. This loss of function may be due to fewer follicles than usual or ovarian dysfunction.

How does ovulation work?

Before we can begin to understand ovarian failure, we need to understand ovulation. In short, a woman is born with approximately 2 million follicles in her ovaries. When you get older and reach puberty, he will have between 300,000 and 400,000 left. The body no longer produces. These follicles are very important as they mature into eggs that are released during ovulation. Now 300,000 may seem like a lot, but not all follicles become mature eggs.

When the menstrual cycle begins, estradiol (estrogen) levels are low. Your hypothalamus (which is responsible for maintaining hormone levels) sends a message to the pituitary gland, which then sends out FSH.

This follicle-stimulating hormone causes some of your follicles to turn into mature eggs. Remember that only one follicle has a chance of becoming a mature egg. As the follicles mature, they release another hormone, estrogen. Estrogen sends a signal to the hypothalamus to stop producing follicle-stimulating hormone. If the follicles do not mature and produce estrogen to stop production of FSH, FSH will continue to be produced and reach high levels.

This is why women with premature ovarian failure are tested for high levels of follicle-stimulating hormone. Once estrogen levels are high enough, the hypothalamus and pituitary gland know that the egg has matured. The luteinizing hormone is then released; this is called the release of luteinizing hormone.

Within 24-36 hours after the release of luteinizing hormone, a mature egg is released and ready for fertilization. During this time, progesterone thickens and prepares the uterine lining for implantation. If fertilization does not occur, the egg will dissolve and after a few days, hormone levels will drop and the lining of the uterus will begin to slough off. This is called menstruation (menstrual period) and brings us back to day 1 of your cycle. Then the journey starts again.

Is there a difference between premature ovarian failure and menopause?

Menopause usually occurs at an average age of 51 years. Premature ovarian failure can occur at any age up to age 40, usually averaging around 27 years of age. When a woman goes through menopause, she no longer has follicles to produce eggs and therefore no longer menstruates. .

In a woman with premature ovarian failure or premature menopause, follicles may be preserved, but they may be depleted or dysfunctional. Therefore, she can still menstruate; however, in most cases, her periods are irregular. Irregular menstruation is one of the signs of premature ovarian failure. Keep in mind that there may be other explanations for the irregular cycle. Always discuss any menstrual irregularities with your doctor.

What are the symptoms?

Irregular periods (different length of bleeding or change inflow)
Hot flashes
Night sweats
A decrease in sexual drive
Irritability
Painful sex
Thinning and drying of the vagina

Some women may continue to have normal periods without any symptoms. The diagnosis can only be discovered when FSH levels are measured and returned with an elevated level. Discuss any menstrual changes or symptoms with your doctor before jumping to conclusions about premature ovarian failure.

What options do I have if I have premature ovarian failure?

Options for women with premature ovarian failure who want to have children include using egg donors, fertility treatment, or seeking to adopt a child.

Doctors may also try various fertility treatments, such as:

Gonadotropin-releasing hormone (GnRH)
Estradiol and corticosteroids (such as prednisone)
Clomid (Clomiphene citrate)
Human menopausal gonadotropins (hMG)
Danazol

None of these treatments have proven effective in restoring fertility, but they are often still used. However, 8% of pregnant women with premature ovarian failure received hormone replacement therapy. Although there is no absolute cure, hormone replacement therapy helps women get pregnant.