Premature Ovarian Failure

Topic Overview

This topic contains information about loss of ovarian function before age 40. If you want information about the normal loss of ovarian function around age 50 or about symptoms in the few years before it, see the topic:

Menopause and Perimenopause.

What is premature ovarian failure?

Premature ovarian failure occurs when your ovaries—which store and release eggs—stop working before age 40. You may have no or few eggs, or your eggs do not develop properly. Depending on the cause, premature ovarian failure may develop as early as the teen years.

Premature ovarian failure is characterized by irregular or no periods, infertility problems, and menopause-like symptoms. It is difficult, though not impossible, for women with premature ovarian failure to become pregnant.

What causes premature ovarian failure?

Although the exact cause of premature ovarian failure may be unknown, a genetic factor or a problem with the body's immune system may play a role. In an immune system disorder, the body may attack its own tissues, in this case the ovaries.

Premature ovarian failure may develop after a hysterectomy or other pelvic surgery or from radiation or chemotherapy treatment for cancer. In some of these cases, the condition is temporary.

What are the symptoms?

The symptoms of premature ovarian failure are similar to those of menopause. Your menstrual periods may become irregular—you have a period one month but not the next—or they may stop. You also may have some or all of the symptoms of menopause, such as hot flashes, night sweats, irritability, vaginal dryness, low sex drive, or trouble sleeping.

How is it diagnosed?

If your periods become irregular or stop, your health professional will give you a physical examination and ask you questions about your general health and whether you have other symptoms of premature ovarian failure. You will also have a pregnancy test and your blood will be tested for other possible causes of period problems.

To check for possible ovarian failure, your blood level of follicle-stimulating hormone (FSH) will be checked. FSH signals your body to release an egg every month. If the amount of FSH in your blood is higher than normal on more than one day, you probably have premature ovarian failure. Another blood test also may be done to measure the amount of estradiol (or estrogen) in your blood. Very low estrogen with a high FSH is a sign of premature ovarian failure.

Some women discover they have premature ovarian failure when they see a health professional because they have trouble getting pregnant.

How is it treated?

No treatment is available to make the ovaries work properly and improve fertility. Your health professional may prescribe hormone replacement therapy, certain types of antidepressants (such as Prozac or Paxil), or other medications to treat hot flashes and other symptoms. Talk to your health professional about which treatments may be appropriate for you.

Some women with premature ovarian failure may choose to try to become pregnant using donor eggs. For more on this treatment, see the topic Fertility Problems.

Finding out you have premature ovarian failure can be extremely upsetting, especially for a woman who hopes to become pregnant. You may want to seek support through counseling. You also can find information and support through the Premature Ovarian Failure Support Group, available online: http://www.pofsupport.org.

Can it be prevented?

At this time, there is no way to prevent premature ovarian failure. However, you can take steps to protect your overall health. Women with premature ovarian failure have an increased risk of bone thinning and fractures (osteoporosis), diabetes, and heart disease. A balanced and low-fat diet, regular exercise, getting enough calcium and vitamin D, and not smoking can help protect your bones and heart. Talk to your health professional about other steps you can take.