6. Definition
Premature ovarian failure is also
known as primary ovarian insufficiency
It refers to a loss of normal function
of ovaries before age 40
Affects 1% of women
Depending on the cause, premature
ovarian failure may develop as early as
the teen years, or the problem may
have been present from birth.
7. Primary ovarian insufficiency
(POI) is characterized by
amenorrhea,
hypoestrogenism, and
elevated serum gonadotropin
levels in
women younger than 40 years.
8. Anatomy
The ovary is a ductless reproductive gland in
which the female reproductive cells are
produced.
Although about 1 million oocytes are present
at birth in the human ovary, only about 500 of
these ovulate, and the rest are wasted.
If the ovaries fail, they won’t produce normal
amounts of the hormone estrogen or release
eggs regularly which will result into Infertility.
9.
10. Causes
Genetic disorders
Autoimmune diseases
Tuberculosis of the genital tract
Smoking
Radiation and/or chemotherapy
Ovarian failure following hysterectomy
Prolonged GnRH (Gonadatrophin Releasing Hormone)
therapy
Enzyme defects
Resistant ovary
Induction of multiple ovulation in infertility
11.
12. Chromosomal defects.
• Certain genetic disorders are associated which
include Turner's syndrome, a condition in which a
woman has only one X chromosome instead of the
usual two, and fragile X syndrome.
Toxins.
• Chemotherapy and radiation therapy are the most
common causes of toxin-induced ovarian failure.
• These therapies may damage the genetic material
in cells. Other toxins such as cigarette smoke,
chemicals, pesticides and viruses may hasten
ovarian failure.
13. Autoimmune:
Immune system may produce
antibodies against own ovarian
tissue, harming the egg-containing
follicles and damaging the egg. What
triggers the immune response is
unclear, but exposure to a virus is
one possibility.
14.
15. Risk Factors
Age : The risk of ovarian failure rises
sharply between age 35 and age 40.
Family history : Having a family
history of premature ovarian failure
increases your risk of developing this
disorder.
16.
17. Symptoms
Irregular or skipped periods (amenorrhea)
Hot flashes
Night sweats
Vaginal dryness
Irritability
Poor concentration
Decreased sexual desire
18.
19.
20.
21. Complications
Infertility. Inability to get pregnant may be the most
troubling complication of premature ovarian failure,
although in rare cases, pregnancy is possible.
Osteoporosis. The hormone estrogen helps
maintain strong bones. Women with low levels of
estrogen have an increased risk of developing weak and
brittle bones (osteoporosis), which are more likely to
break than healthy bones.
Depression or anxiety. The risk of infertility and
other complications arising from low estrogen levels
may cause some women to become depressed or
anxious.
22. Tests & Diagnosis
Follicle-stimulating hormone (FSH) test.
FSH is a hormone released by the pituitary gland that
stimulates the growth of follicles in the ovaries.
Women with premature ovarian failure often have
abnormally high levels of FSH in the blood.
POF patients is over 40 mlU/ml (post-menopausal
range).
Estradiol test.
The blood level of estradiol, a type of estrogen, is
usually low in women with premature ovarian failure.
Prolactin test
High levels of prolactin the hormone that stimulates
breast milk production in the blood can lead to
problems with ovulation.
23. Tests & Diagnosis
Karyotype.
This is a test that examines all 46 of your
chromosomes for abnormalities. Some women with
premature ovarian failure may have only one X
chromosome instead of two or may have other
chromosomal defects.
FMR1 gene testing.
The FMR1 gene is the gene associated with fragile X
syndrome an inherited disorder that causes
intellectual problems. The FMR1 test looks at both
of your X chromosomes to make sure they appear
to be normal
24. Treatment
en therapy.
To help prevent osteoporosis and relieve hot flashes
and other symptoms of estrogen deficiency, Estrogen is
typically prescribed with another hormone called
progesterone.
Adding progesterone protects the lining of your uterus
(endometrium) from precancerous changes caused by
taking estrogen alone.
In older women, long-term estrogen plus progestin
therapy has been linked to an increased risk of heart and
blood vessel (cardiovascular) disease and breast cancer.
In young women with premature ovarian failure,
however, the benefits of hormone replacement therapy
for heart health may outweigh the potential risks.
25. Treatment
Calcium and vitamin D supplements.
Both calcium and vitamin D are important for
preventing osteoporosis.
A bone density test shall be suggested before
starting supplements to get a baseline bone
density measurement.
For women ages 19 through 50, the Institute of
Medicine recommends 1,000 milligrams (mg) of
calcium a day through food or supplements,
increasing to 1,200 mg a day for women age 51
or older.
