Premature ovarian failure
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| ICD-9 | 256.31 |
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Premature Ovarian Failure (POF), also known as early menopause, is the cessation of menstrual periods and ovulation in women under the age of 40. Hormonally, it is defined by abnormally low levels of estrogen and high levels of FSH, demonstrating that the ovaries are no longer responding to circulating FSH by producing estrogen and developing fertile eggs. The ovaries will likely also appear shriveled. Age of onset can be as early as the teenage years but varies widely. If a girl never begins menstruation, it is called primary ovarian failure. The age of 40 was chosen as the cut-off point for a diagnosis of POF somewhat arbitrarily--as all women's ovaries decline in function over time, an age needed to be chosen to distinguish usual menopause from the abnormal state of premature menopause. However, premature ovarian failure often has components to it that distinguish it from normal menopause.
By the age of 40, approximately one percent of women have POF. Women suffering from POF usually experience menopausal symptoms, which are generally more severe than the symptoms found in older menopausal women. Some cases of POF are attributed to an autoimmune disorder, others to genetic irregularities such as Fragile X syndrome, while the cause of other cases remains unknown. Chemotherapy and radiation treatments for cancer can sometimes cause ovarian failure. In such cases, the resulting hormone profile more closely resembles that of a woman with no ovaries, than that of a woman who has undergone natural menopause. In natural menopause, the ovaries usually continue to produce low levels of hormones, but in chemotherapy-induced POF, the ovaries will often cease all functioning. Between 5 and 10 percent of women with POF become pregnant; ovulation can occur occasionally even after a diagnosis of POF. Currently no fertility treatment has been found to effectively increase fertility in women with POF, and the use of donor eggs has become more popular as a means of having children for women with POF.
Due to their low estrogen levels, women with POF are at an increased risk for osteoporosis and cardio-vascular problems. Hormone replacement therapy can restore estrogen levels to the normal range and can slow bone loss.
http://www.nichd.nih.gov/publications/pubs/pof/sub1.htm#what http://www.earlymenopause.com
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