Primary ovarian insufficiency

Primary ovarian insufficiency (sometimes called premature ovarian failure) occurs when your ovaries-which store and release eggs-stop working before age 40. You may have no or few eggs. Depending on the cause, primary ovarian insufficiency may develop as early as the teen years, or the problem may have been present from birth.

The symptoms of primary ovarian insufficiency are similar to those of menopause. Your menstrual periods may become irregular—you have a period one month but not the next—or they may stop. You also may have some or all of the symptoms of menopause, such as hot flashes, night sweats, irritability, vaginal dryness, low sex drive, or trouble sleeping.

Symptoms can also include fertility problems. It may be more difficult, though not impossible, to become pregnant.

If your periods become irregular or stop, your doctor will give you a physical exam and ask you questions about your general health and whether you have other symptoms of primary ovarian insufficiency. You will also have a pregnancy test and blood tests.

To check for possible ovarian insufficiency, your blood level of follicle-stimulating hormone (FSH) will be checked. FSH signals your body to release an egg every month. If the amount of FSH in your blood is higher than normal on more than one day, you may have primary ovarian insufficiency. Another blood test also may be done to measure the amount of estradiol (or estrogen) in your blood. Very low estrogen with a high FSH is a sign of primary ovarian insufficiency. Your blood may also be tested for other possible causes of irregular periods. This includes blood tests that check prolactin levels and thyroid function.

Some people find out they have primary ovarian insufficiency when they see a doctor because they are having trouble getting pregnant.

Treatment for primary ovarian insufficiency will help you manage your symptoms. But there is currently no treatment that will make the ovaries start to work properly again. Your doctor may prescribe hormone therapy or other medicines to help with hot flashes. Hormone therapy can also help prevent early bone loss. Talk to your doctor about which treatments may be right for you.

Some people with primary ovarian insufficiency may choose to try to become pregnant using donor eggs and in vitro fertilization.

Finding out you have primary ovarian insufficiency can be upsetting. You may want to get support through counseling. You can also find information and support at www.resolve.org from Resolve: The National Infertility Association.