What is Premature Ovarian Insuffiency?
If you lose normal function of your ovaries long before the age of 40, even at a very young age, then it's called Premature Ovarian Insufficiency or Premature Ovarian Failure.
Symptoms and Causes of Premature Ovarian Insufficiency
The symptoms for Premature Ovarian Insufficiency are typical of estrogen deficiency:
If - as a young girl or as as woman under 40 - you've missed your period for three months or longer, then it's best to see your doctor. When your menstrual cycle changes, it can be for a whole range of reasons: stress, pregnancy, or even a change in your diet. You might "not mind" the lack of periods, but it's important to know that this indicates a low oestrogen level. And that can lead to bone loss.
Having good, clear and open communication about the female body, your cycle and your period, is a healthy start. Because it's definitely okay to talk about this. It helps to know that you can go to a nurturing and safe place to find help or advice. I am here to help you as a teenage girl, and I am here to help you if you are a parent of a teenage girl.
So what is actually going on when you have Premature Ovarian Failure?
When your ovaries are doing their normal job, one of your glands (the pituitary gland) releases a hormone during your cycle every month, so a small number of follicles in your ovaries start maturing. The follicles are tiny sacs filled with fluid and they contain eggs. The follicle matures, opens, and releases the egg. In the fallopian tube it can then meet a sperm cell, get fertilised, and get you pregnant.
Loss of eggs
You are born with the set number of eggs you are ever going to have and these run out of the course of your life. If they run out earlier than expected (< 40 years of age) this is known as premature ovarian insufficiency (POI).
There are many different causes of POI with many of the causes being unknown. Sometimes it is because you have an abnormality in the number of chromosomes (eg Turner syndrome) or sometimes there is a mutation in your genes that has lead to this. There are also autoimmune conditions that are associated with POI including thyroid and adrenal autoimmune diseases. Environmental toxins including radiation and chemotherapy used for cancer can also deplete the store of eggs early. As an adolescent, you can develop this condition, but it's more common between the ages of 35 and 40. If there's a family history of Ovarian Insufficiency, then that increases your risk.
The most important thing is that when you don’t have periods due to POI you will have no estrogen in your body and this can have other consequences such as affecting your bone health and heart health. In addition to this the prospect of being infertile can have devastating impact and increase the chances of mental health disorders. POI needs to be managed long term by a reproductive endocrinologist skilled in this area.
Your specialist might recommend one of the following tests:
- Pregnancy test Checks for unexpected pregnancy
- Follicle-Stimulating Hormone (FSH) test. Your pituitary gland releases this hormone, and it stimulates the growth of follicles in your ovaries. So if you have Premature Ovarian Failure, you would have abnormally high levels of it in your blood.
- Estradiol test:Estradiol is a type of estrogen coming from the ovaries. If you have Premature Ovarian Insufficiency, the level of it in your blood will be very low.
- Prolactin test: Prolactin is the hormone that stimulates the production of breast milk. Now if that level in your blood is too high, you can experience irregular or absent menstrual periods.
- Karyotype:This is a test to check your 46 chromosomes. Abnormalities include: only having one X chromosome instead of 2.
- FMR1 gene testing: The FMR1 gene is the gene associated with Fragile X Syndrome. The test looks at both your X chromosomes, making sure they are normal. If you have inherited Fragile X Syndrome, then the gene could cause intellectual problems for children you conceive.
Treating Premature Ovarian Insufficiency
Learn about the treatment for Premature Ovarian Insufficiency.
Use the link to learn more about Müllerian Anomalies.
Primary and Secondary Amenorrhea
Learn more about symptoms, causes and diagnose for Primary and Secondary Amenorrhea.