Premature Ovarian Insufficiency - Medtick

Premature Ovarian Insufficiency

What is it?

Where one has a low level oestrogen and/or where the ovaries stop functioning leading to lower egg production, and fertility difficulties before the age of 40 years, it used to be known as premature ovarian failure.

  • It differs from early menopause, which occurs in women aged between 40 and 45 years.

Diagnosis Tests

  • Blood tests and other presenting with menopausal symptoms
    • Results are : Elevated serum follicle stimulating hormone (FSH) levels (>30 IU/L) on two consecutive blood samples taken four to six weeks apart.

Premature Ovarian Insufficiency: Information for patients. The Leeds Teaching Hospitals NHS Trust. 2019.
http://flipbooks.leedsth.nhs.uk/
LN003682P/LN003682.pdf (accessed May 2022).

  • One may undergo tests that check your hormone levels, especially follicle stimulating hormone (FSH), which is the hormone that causes your follicles to develop and release an egg, and prolactin, the hormone that causes you to produce milk.
  •  Anti-Müllerian hormone (AMH) levels may be checked as well to assess your egg count.
    • Understanding the hormonal activity in your body can help your doctor rule out other conditions.
  • You may also need genetic tests, especially karyotype test and tests for the FMR1 genetic difference. These tests help identify genetic conditions that can lead to POI.
  • The doctor may also test your bone density.
    • Since estrogen reduction can cause your bones to weaken, they may want to look for signs of osteoporosis.
  • An ultrasound may be performed to count your antral (ovarian) follicles, which contain your immature egg cells.

Heathline


Diagnosis Tests

  • Blood tests
  • Once confirmed: Rule out other medical conditions to which it can be confused with (see ‘similar to’ section below).

Cause

Treatments

  • Chemotherapy
  • Ovarian surgery
  • Radiation

Syndromes

Medication

  • Cancer medication

Increased risk:

Symptoms

(Symptoms vary from individual to individual)

  • Hot flushes and/or flushed face and/or warm skin and/or slight sweating, and/or dislike to heat?
  • Night sweats?
  • Heart palpitations and/or irregular heartbeats?
  • Infertility problems?
  • Dry skin?
  • Thinning hair?
  • Dry eyes and/or watery eyes (tears not controlled)?
  • Headaches?
  • Breast tenderness?
  • Fat redistribution of their body/changing shape of body?
  • Needing to pass urine more often and Overactive (urgency to go to toilet)?
  • Re-occurring burning and/or pain when urinating?
  • Loss interest of sex and/or low sex drive?
  • Experience dryness and itchiness in vagina and/or making sexual intercourse painful?

Emotional:

  • Irritated, depressed, anxiety and/or panic attack and/or emotional (laugh or cry for no reason)  and/or lowered self-esteem?
  • General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)?
  • Difficult to concentrate and/or difficulty in concentrating and/or memory problems?
  • Difficulty sleeping and/or lack of sleep and/or feeling of not having a good night sleep (insomnia)?

Complications /Information to beware of/General tips:

Do not wait, phone for an ambulance if have or develop:


This condition can lead to:


When an autoimmune disorder has caused POI, you may be at greater risk for the following conditions:

Healthline


Hormone replacement therapy

Replacing these hormones can relieve some of your symptoms, including:

  • Hot flushes
  • Night sweats
  • Insomnia
  • Menstruation (period) issues

One cannot use this treatment (unless on specialist advice):

Side effects of Hormone Replacement Therapy (HRT)

  • Unscheduled vaginal bleeding within the first three months of the regimen and is different to the regular, scheduled bleeding that occurs at the end of the progesterone phase in cyclical regimens

Scenario: Managing women with menopause, perimenopause, or premature ovarian insufficiency. National Institute for Health and Care Excellence. 2022.https://cks.nice.org.uk/topics/
menopause/management/management-of-menopause-perimenopause-or-premature-ovarian-insufficiency (accessed May 2022).

  • Continuous combined HRT can also result in irregular breakthrough bleeding or spotting in the first four to six months of treatment.
  • If bleeding persists beyond six months or reoccurs after a period of reported amenorrhea then a medical doctor needs to investigate endometriosis.
  • Oestrogen-related adverse effects:
  • Progesterone related  Adverse effects:

This condition may show similar symptoms to:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Premature Ovarian Insufficiency in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

  • NHS

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  • Pharmaceutical Journal

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  • Drugs.com

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  • National Organisation of Rare Diseases

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  • Verywell Health

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References

The Pharmaceutical Journal, PJ, May 2022, Vol 308, No 7961;308(7961)::DOI:10.1211/PJ.2022.1.142437

https://www.healthline.com/health/womens-health/primary-ovarian-insufficiency