One per cent of women under the age of 40 are affected by premature ovarian failure (POF), in which an individual's eggs are lost, do not function properly, or are damaged as a result of cancer treatment. Women who experience POF suffer from premature menopause. Although premature ovarian failure is often referred to as premature or early menopause they are not one in the same. Within this blog I am referring to both conditions as once a woman has POF she will develop premature menopause and therefore they are difficult to separate.
"Premature ovarian failure brings with it a wrenching emotional change along with the physical. Your emotions are already affected by the fluctuating hormones in your body and the reality of your condition impacts on your emotions even more. The single most upsetting element of premature ovarian failure, according to all the women surveyed, was the most basic: their loss of reproductive capacity. It didn’t make a difference if they had children or not - or even if they had been trying to have children. The sudden switch from fertile woman to irrevocably infertile woman was the biggest blow of all."
Ref: http://www.daisynetwork.org.uk/index.html
Primary premature ovarian failure
Primary premature ovarian failure can occur at any age, even in children. It can present as either primary or secondary absence of periods. In the great majority of cases no cause can be found.
Causes of premature ovarian failure
In the majority of cases no obvious cause can be identified. Just because you do not have a logical reason, doesn’t take away the impact that a premature menopause can have and in some cases it can make it harder to come to terms with.
In 95 percent of women who develop POF spontaneously, the cause is unknown. The other 5 percent of cases are thought to be either genetic or autoimmune-related. Some experts think that stress, environmental toxins and alcohol consumption may contribute to POF, although no firm conclusions have been reached.
Ref: http://www.womansday.com/Articles/Health/Conditions-Diseases/Checkup-Premature-Ovarian-Failure.html
Primary premature ovarian failure is when a woman’s ovaries stop working and it is usually not possible to explain why this happens. The reasons can include:
•Chromosome abnormalities, such as in women with Down’s syndrome.
•Enzyme deficiencies, where enzymes in the body affect the ovaries by damaging the eggs and preventing the production of oestrogen.
•Autoimmune diseases, where the body’s natural defence mechanisms start producing antibodies that destroy its own tissues.
Secondary premature ovarian failure
Secondary premature ovarian failure can be due to radiotherapy or chemotherapy. The risk of POF depends on the type of treatment given and the age of the patient. Younger women who have not reached puberty can tolerate stronger treatment than older women without losing fertility. It might be possible to remove eggs for storage, prior to treatment.
Other causes include surgical menopause, which is an operation to remove both ovaries, or hysterectomy, which is surgery to remove the womb. Infections, such as tuberculosis and mumps, can also cause POF, though this is rare. Other infections linked to POF include malaria and chickenpox.
http://www.nhs.uk/Livewell/menopause/Pages/Prematuremenopause.aspx
Consequences of premature ovarian failure
Women with untreated premature ovarian failure are at increased risk of developing osteoporosis, cardiovascular disease, dementia, cognitive decline and Parkinsonism and all cause mortality.
Prior to menopause, our ovaries are responsible for producing the majority of estrogen that is present in our bodies. One of the first things to understand is that women with premature ovarian failure need to take special care to protect themselves from the risks associated with lower estrogen production at an earlier age. After menopause, the body is able to adjust to lower amounts of estrogen, but for women in their 20’s, 30’s, and 40’s certain hormonal levels are necessary to maintain good health. This is why many women with POF benefit from hormone replacement therapy.
Treatment
HRT is normally recommended until the average age of the natural menopause (52) The regimens used will depend on whether the woman has undergone hysterectomy or not, or whether she still has some ovarian activity and still has periods.
There is no evidence that HRT increases risk of breast cancer and cardiovascular disease over and above that found in menstruating women with a normally timed menopause for this age group.
http://www.thebms.org.uk/
