Premature ovarian failure
From Wikipedia, the free encyclopedia
| ICD-10 | E28.3 |
|---|---|
| ICD-9 | 256.31 |
| DiseasesDB | 9441 |
| eMedicine | med/1700 |
| MeSH | D016649 |
Contents |
[edit] Definition
Premature Ovarian Failure (POF) affects approximately 1-4% of the female population in the U.S., which, is about 250,000 to one million women. Normally, ovaries supply women with eggs until about 51 years old, which is approximately when menopause occurs. POF is not menopause in that the dysfunction of the ovaries, loss of eggs, or removal of the ovaries at a young age is not a normal occurrence. Infertility is the most referred to outcome of having this condition, but more is being discovered about additional health implications through on-going research studies. Osteoporosis or lowered bone density affects almost all young women with POF due to the effects of living with diminished estrogen on bones. There is also an increased risk of heart disease, hypothyroidism in the form of Hashimoto's thyroiditis, Addison's disease, and other auto-immune disorders for women with POF.
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.
[edit] Causes
Often times, the cause of POF is unknown. Some cases of POF are attributed to autoimmune disorders, others to genetic disorders such as Turner syndrome and Fragile X syndrome. In many cases, the cause cannot be determined. Chemotherapy and radiation treatments for cancer can sometimes cause ovarian failure. In natural menopause, the ovaries usually continue to produce low levels of hormones, but in chemotherapy or radiation-induced POF, the ovaries will often cease all functioning and hormone levels will be similar to those of a woman whose ovaries have been removed.Women who have had their tubes tied, or who have had hysterectomies, tend to go through menopause several years earlier than average, likely due to decreased blood flow to the ovaries. Family history and ovarian or other pelvic surgery earlier in life are also implicated as risk factors for POF.
The POF Fact Sheet is now available in 6 languages and lists potential causes of POF:
English: http://www.pofsupport.org/information/factsheet/fact_sheet_english.pdf
Spanish: http://www.pofsupport.org/information/factsheet/fact_sheet_spanish.pdf
French: http://www.pofsupport.org/information/factsheet/fact_sheet_french.pdf
German: http://www.pofsupport.org/information/factsheet/fact_sheet_german.pdf
Italian: http://www.pofsupport.org/information/factsheet/fact_sheet_italian.pdf
Japanese: http://www.pofsupport.org/information/factsheet/fact_sheet_japanese.pdf
[edit] Fertility
Between 5 and 10 percent of women with POF may spontaneously become pregnant. Currently no fertility treatment has been found to effectively increase fertility in women with POF, and the use of donor eggs and adoption have become more popular as a means of becoming parents for women with POF. More women with POF are also choosing to live child-free.
[edit] External links
The leading resource of POF info is the International Premature Ovarian Failure Association (IPOFA) which is a 501 (c) 3 nonprofit organization based in Virginia, founded in 1995. IPOFA is fully supported by membership dues and tax-deductible donations and is currently run by six volunteers living throughout the United States who make up the Executive Board of Directors, and by the many other dedicated volunteers who are the lifeblood of the organization. International Premature Ovarian Failure Association http://wwwpofsupport.org
U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, NICHD Information Resource Center, Do I have Premature Ovarian Failure? NIH pub. No. 03-5159, August 2003. You can order free copies by calling 1-800-370-2943, and it’s also available for download at http://www.nichd.nih.gov/publications/pubs/pof/upload/premature_ovarian_failure.pdf
National Institutes of Health/ Premature Ovarian Failure website http://eclipse.nichd.nih.gov/nichd/deb/geuPOF/resources.htm
Current POF Clinical trials via the NIH recruiting patients http://www.clinicaltrials.gov and search “premature ovarian failure”
"What's The Best Approach To Spontaneous Premature Ovarian Failure?", by Dr. Lawrence Nelson, Principal Investigator at NIH for POF research studies/clinical trials. http://pof.nichd.nih.gov/Contemp_ObGyn_2004_POF.pdf
Women with premature menopause at increased risk for potentially fatal adrenal condition-early diagnosis can lead to effective treatment, NIH News Release. http://www.nih.gov/news/pr/aug2002/nichd-30.htm. Nelson, L., 2002.
Irregular periods in young women could be warning sign for later osteoporosis, NIH News Release. http://www.nih.gov/news/pr/may2002/nichd-29.htm. Nelson, L., 2002.
