Primary Ovarian Insufficiency (POI) or Premature Menopause in Younger Women

Around age 50, there are changes which occur in most women that can wreak havoc on their lives.  Bothersome symptoms, such as hot flashes, night sweats, cessation of menstrual periods, and difficulty sleeping are only some of the issues that can occur during this stage of life. There is however, a condition called Primary Ovarian Insufficiency (POI) or Premature Ovarian Failure (POF), in which these very same symptoms appear in women. Except in these cases, instead of happening after age 50, women with this condition have these symptoms happen to women who are younger than 40 years old.

There is not much known about this disease, so if you go to your family doctor and complain of these symptoms, it may be difficult to get an appropriate diagnosis. Having menopausal symptoms before the normal age that menopause begins can be distressing and disturbing for women.  Some have referred to the condition as a “premature menopause” or “premature ovarian failure” (POF), primarily because studies have found that the function of the ovaries is irregular in women diagnosed with POI.  Some physicians may prefer to use the label of Primary Ovarian Insufficiency because the ovaries in women having the condition may fluctuate between a working and non working state. 

Infertility with POI is likely, and the problems associated with becoming pregnant can occur because the ovarian function is diminished. Some estimates have stated that there are about 5-10 percent of women diagnosed with POI who could potentially become pregnancy even without receiving any medical care. 

hotflashestooearly Other Health Issues with POI:

*  Risk of Osteoporosis and Bone Fractures
*  Increased Risk of Heart Disease
*  Potential to Develop Addison’s Disease (which is a Disease of the Endocrine System affecting the Adrenal Glands)
*  Hypothyroidism or Problems with Low Thyroid Function

Symptoms that Should Not Be Ignored:

**   Missing or irregular Periods **

A National Institutes of Health Physician, Dr. Lawrence M. Nelson, says that “Many women aren’t aware they have POI, and some teens and young women think of the menstrual cycle as a nuisance, and they don’t mind missing periods. They don’t take it seriously, and that’s a mistake.”

How Many People does Primary Ovarian Insufficiency Affect?

Photo Courtesy: National Institutes of Health

The incidence of POI increases as a woman ages. For example, at the age of 20, there may be one in 10,000 who are affected, by the age of 30, the number of cases rises to one in 1,000. At the age of 35, there could be one woman for every 250 women who are diagnosed with POI,  and by the time a woman reaches age 40, there is a one in 100 chance that a woman could be diagnosed with Primary Ovarian Insufficiency.

Any change in a women’s menstrual cycle should always be brought to the attention of their health care provider. Because irregular periods are commonly found in women with POI, it is very important for women to pay attention to their menstrual cycles during all of the life stages.

What Can Women Do If They’re Having Difficulty Conceiving?

You can ask your healthcare professional to check certain hormone levels in your blood. FSH, which is one of the most critical hormones related to the reproductive health in women, may be tested to determine to determine how likely it is that a woman may have a successful pregnancy. Otherwise known as Follicle Stimulating Hormone, FSH levels are important to test during certain times in your menstrual cycle. Ask your clinician the best time to test your FSH levels in order to get the most accurate baseline level before having your labs drawn.

Under the age of 40 if a woman goes into her healthcare provider with complaints of irregular periods, or if a period has been missed for 3 months or longer, the healthcare professional may ask the woman to get a FSH test. This is done to determine if POI is an issue that is just developing, or even if possibly POF (Premature Ovarian Failure) has already occurred.

There is a hormonal “dance” if you will that happens among hormones which control the amount and type of different chemicals that are secreted in the body. FSH tells the ovaries to produce estrogen. In the case of POI or even POF, when the ovaries aren’t functioning correctly, the hormone level of FSH will increase. So having high levels of FSH is a warning sign to consider POF as a diagnosis for your healthcare provider.  

Woman shouldn’t always associate having missed or irregular periods however with having POI Or POF. Statistically, there are less than 10 percent of woman whose FSH levels are elevated and who are diagnosed with POF. So it isn’t the irregularity of periods alone that lead all of the time to a POI or POF diagnosis.

FSH levels are tested through a regular blood draw. Once the sample is taken from your arm it is packaged and sent off to a laboratory. There, lab technicians will check FSH levels, and if the levels come back as being results that are in the range for menopausal women it is typically found that you may have POI or POF.