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A Quick Guide to Understanding Primary Ovarian Insufficiency (POI) or Premature Ovarian Failure (Menopause)

Primary Ovarian Insufficiency (POI), also known widely as menopause or premature ovarian failure, is a condition where a woman’s ovaries stop functioning even before the age of 40. A healthy woman’s ovaries function normally to produce a hormone called estrogen. Estrogen is responsible for regulating menstrual periods and keeping you fertile to get pregnant. When a woman approaches advanced age, their ovaries stop producing estrogen which is a normal process.


However, in some cases, a woman’s ovaries stop functioning way before menopause is expected. While the average age for hitting menopause is 51 and if you’re 40 or less than that and your ovaries have stopped producing eggs causing your periods to stop, you have what is called primary ovarian insufficiency.


Primary Ovarian Insufficiency Causes


Ovarian failure caused in more than 90% of cases is still unknown. Several studies and research have indicated towards follicles as one of the major causes of ovarian failure. Follicles are small sacs located in your ovaries where eggs grow and mature inside. One of the follicle issues occurs when your ovaries no longer have working follicles than before while the other could be that the existing follicles aren’t functioning properly to support egg growth. 


Whatever may be the case, the cause of follicle issues remains unknown. However, some common ovarian failure causes are:

  • Genetic disorders can be attributed to premature ovarian failure; such genetic disorders include Fragile X syndrome and Turner Syndrome
  • Reduced number of follicle counts
  • Certain autoimmune disorders like thyroiditis or Addison disease
  • Chemotherapy or Radiation Therapy
  • Certain metabolic disorders
  • Exposure to toxins released due to smoking cigarettes, pesticides, and chemicals


Primary Ovarian Insufficiency Symptoms


One of the first clear and evident signs and ovarian failure symptoms is irregular or missed periods. However, the later symptoms of ovarian failure are similar to that of menopause. Here are some widely noticed ovarian failure symptoms or primary ovarian insufficiency symptoms:

  • Hot flashes
  • Breaking into night sweats
  • Poor concentration ability
  • Mood irritability
  • Decreased libido or poor sex drive
  • Pain during sex
  • Vaginal dryness
  • Anxiety, depression, and mood swings
  • Trouble getting a peaceful sleep


Primary Ovarian Insufficiency Risk Factors


There are certain factors that increase a woman’s risk of having ovarian failure, here they are:

  • Family History – Women with a family history of primary ovarian insufficiency or early menopause are highly likely to get it than those without any family history of POI.
  • Genetic Conditions – There are certain genes and genetic conditions that put women at higher risk of developing POI. For instance, women affected with Turner Syndrome or Fragile X Syndrome are exposed to a greater risk of getting ovarian failure.
  • Specific Diseases – Certain diseases such as viral infections and autoimmune diseases make women highly vulnerable to suffering POI or ovarian failure.
  • Cancer Treatments – Women undergoing certain cancer treatments like chemotherapy and radiation therapy makes women susceptible to suffering ovarian failure.
  • Age – Though primary ovarian insufficiency can affect women of any age but it gets more common as you mature. Women with matured ages are more vulnerable to having POI.


Primary Ovarian Insufficiency Diagnosis


Your healthcare provider can establish an ovarian failure diagnosis based on the following:

  • Medical History – You will be asked about your medical history and your family’s history to assess if any of your sisters or mother had a POI.


  • Physical Exam – Your healthcare provider will ask about your physical symptoms your menstrual history and your pattern to reach a diagnosis. 


  • Pathological Exam – Your healthcare provider will ask you to undergo certain hormone tests to check for hormonal levels. You will also be asked to do a chromosome analysis to assess your genetic information.


  • Pregnancy Test – You will be asked to undergo a pregnancy test to rule out chances of the same.


  • Pelvic Ultrasound – Your doctor will order you to get a pelvic ultrasound done to check for enlargement of ovaries or multiple follicles.


Primary Ovarian Deficiency Treatment


Once the ovaries stop functioning normally, there’s no treatment to restore it. However, the symptoms of POI or pre-mature menopause can be managed by appropriate treatment. additionally, there are certain treatment plans that can lower your risk of having premature ovarian failure or menopause or treat the conditions that end up causing POI. 


  • Hormone Replacement Therapy (HRT) – Premature ovarian failure occurs when your ovaries are unable to produce estrogen. HRT or hormone replacement therapy is where you are given hormones like estrogen that your ovaries are unable to produce. Taking HRT also works wonders in improving your sexual health and reducing your risk of getting heart disease and osteoporosis in the longer run. 
  • Calcium & Vitamin D Supplements – Since women with premature menopause or ovarian failure are at an increased risk of developing osteoporosis. Doctors usually recommend taking calcium and vitamin D supplements every day to all women above the age of 30 to delay the risk of getting POI.
  • In-vitro Fertilization (IVF) – If you are suffering from POI and are trying to conceive, your doctor will advise you to go for IVF.
  • Staying Active & Watching Weight – Maintaining a healthy body weight and exercising for a minimum of 4 days a week will delay or reduce your risk of having heart disease or osteoporosis.


Medanta Medical Team
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