Premature ovarian failure is a decrease in the activity of ovarian hormones in women before the age of 40.
Author: Stavroulas (Lina) Paschou*
This is a condition that causes low estrogen levels in the blood, irregular menstrual cycles, and finally amenorrhea, i.e. the absence of menstruation. If the above occurs between the ages of 40 and 45, the condition is called early menopause*. Menopause is considered normal after the age of 45, the average age in the Western world is 51 years.
Premature ovarian failure affects about 1% of women. This is due to genetic reasons, autoimmune reasons, destruction of ovarian tissue after surgery or chemotherapy, etc.
In a large part of women (up to 85%), the exact cause is not found (idiopathic). There are no clear diagnostic criteria. Predominant today are: amenorrhea or scanty menorrhoea for at least 4 months and FSH level >25 IU/l in 2 readings at least 4 weeks apart. Anti-Müllerian hormone (AMH) measurement is not used to diagnose premature ovarian failure.
Pregnancy complications and other effects
The reduction or cessation of ovarian function leads to infertility, a phenomenon that has emotional and other consequences for both the patient and those around him. Of course, natural conception and pregnancy are not impossible for these women.
In addition, decreased estrogen concentrations result in vasomotor symptoms such as hot flashes and sweating, urogenital atrophy, decreased sexual desire, and possibly fatigue.
In the long term, these women are multifaceted in terms of bone, metabolic, cardiovascular and mental health. Indeed, they show an increase in osteoporosis and fractures, type 2 diabetes and various cardiovascular problems.
Hormone replacement therapy
The main effects of early ovarian failure can be prevented by exogenous administration of hormone replacement therapy. Treatment involves cyclical administration of estrogen and progesterone until the age of natural menopause, which is around age 50.
Estrogen is given orally or transdermally, and progesterone is given orally, transdermally or vaginally. It is very important to make a correct and timely diagnosis because it is only an effective treatment. This requires increasing the awareness of both the female population and the medical world about premature ovarian failure.