Early ovarian failure

What is premature ovarian failure?

Premature ovarian failure, also known as primary or premature ovarian failure, occurs when women under the age of 40 (1 in 100) begin to have periods of menstrual irregularity, and less ability to become pregnant because the ovaries are no longer functional. It differs from premature menopause because in the latter the periods disappear completely, sometimes abruptly, either because of a disease that facilitates it or spontaneously; however, with premature ovarian failure there may still be occasional periods and therefore the possibility of getting pregnant.

It is important to keep in mind that, depending on certain factors such as family history, genes, certain autoimmune diseases or viral infections, age and some cancer treatments can increase the risk of primary ovarian failure.

What are the symptoms of early ovarian failure?

The main symptoms are absent or irregular menstruation. Other symptoms may be similar to those of natural menopause, such as hot flashes, vaginal dryness, irritability, pain during intercourse or decreased sexual desire, night sweats or lack of concentration.

Premature ovarian failure can also cause other problems due to low levels of certain hormones. These include anxiety and depression, heart disease, infertility, hypothyroidism, ocular surface disease or osteoporosis.

How is early ovarian failure diagnosed?

In order to diagnose early ovarian failure, it is important to take into account the patient’s medical history to find out if there is a family history. A blood test and pelvic ultrasound are essential. The analysis will show the levels of some hormones and the pelvic ultrasound will serve to analyze if the ovaries have follicles or the volume they present. A pregnancy test is also performed to rule out this option, in addition to a physical examination to see if there may be any other disease that is causing the symptoms.

What is the cause of early ovarian failure?

In most cases premature ovarian failure is of unknown cause, about 90%, although there is research linking premature ovarian failure to problems in the follicles, small sacs in the ovaries where the eggs grow and mature. If the follicles do not function well or stop functioning altogether, no oocytes are produced and premature ovarian failure is triggered. The causes of this problem are also often unknown, but some of them may be due to autoimmune diseases such as thyroiditis or Addison’s disease, genetic diseases such as Fragile X syndrome or Turner’s syndrome, or toxins such as tobacco smoke, chemicals or pesticides.

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Can early ovarian failure be prevented?

Early ovarian failure is not something that can be prevented, although it is important to follow a series of tips that can help prevent some symptoms or other referrals. It is important to take calcium and vitamin D to prevent the risk of osteoporosis, to exercise regularly and to control weight to lower the risk of heart disease.

Treatments for early ovarian failure

To treat premature ovarian failure, there is no proven effective treatment to bring the ovaries back into proper function. However, there are some treatments to combat some of the symptoms and conditions that may develop.

Hormone replacement therapies can be applied until menopause begins to produce estrogen and other hormones that the ovaries are not producing, thus improving sexual health. In vitro fertilization may also be performed if there is a desire to become pregnant.

Medications for early ovarian failure:

As mentioned there is no treatment to improve or restore ovarian activity.

Therapy with oral or transdermal estrogens with oral or vaginal progesterone supplementation is advised to make up for the hormones that are not secreted. It is a treatment that is maintained as long as necessary and avoids the side effects of not producing these hormones naturally. It is well tolerated and the best option is recommended by your regular gynecologist.

Currently, Assisted Reproduction Centers are considering treatments to activate the ovarian reserve or what is defined as “ovarian rejuvenation”, although it is still in its initial stages and only a small group of patients will benefit from these therapies.

It is always necessary to evaluate each case and confirm if the appropriate criteria for these treatments are met.

A healthy diet, with adequate vitamin intake and regular physical activity, will also be essential.

Which specialist treats you?

Early ovarian failure can be treated by different specialties, all of them important: gynecology, endocrinology and psychology, especially for the process of acceptance that is needed and to control the different states of mind through which one passes.

In the case of gestational desire, Assisted Reproduction Centers would play an important role in guiding these patients in achieving the desired pregnancy.