I. Definition
Premature ovarian failure is also known as primary ovarian insufficiency. It is defined as a condition of women before age of 40 of which the brain does not response to high levels of FSH in making egg, due to an insufficiency of estrogen.
II. Diagnosis
If you have some of the symptoms below, your doctor may order a blood test for hormones and the levels of FSH hormone, if your blood test indicated a high levels of FSH (follicle Stimulating Hormone), you may suspect to have premature ovarian failure. It's usually necessary to repeat the blood test to make sure the first test was correct. Sometimes, a chomid challenging test is require to confirm the first test result.
III. Causes
The causes of POFs is known, but some researchers suspect
1. Autoimmune disorders
It is caused by abnormal function of immune system in producing antibody antigen that destroys the body tissues, leading to the destruction of ovarian function.
2. Turner syndrome
It is genetic cause of POF as resulting of a complete or near-complete loss of the second X, because it requires to have 2 functioning X chromosomes for normal ovarian function.
3. Fragile X syndrome
It is the most common cause of inherited mental impairment and associated with premutation form of the FMR1 gene, leading to increasing the risk of premature ovarian failure or early menopause.The premutation form of the FMR1 gene can be easily detected in blood or cheek cells via a DNA test.
4. Chemotherapy and radiation
It is said that chemotherapy and radiation to the pelvic region may damage the uterus, leading to abnormal function of the ovaries resulting in infertility and early menopause.
6. Surgery
Any sugery involve removal of the uterus without removing the ovaries may increase the risk of premature ovarian failure.
7. Enzymes deficiency
It is asid that women can not produce enough certain enzymes such as enzyme 17 alpha hydroxylase and 17 and 20 lesmolase may increase the risk of POF as resulting of low levels of estrogen being produced.
8. Infection
Infections such as chickenpox, malaria, tuberculosis and mumps may increase the risk of premature ovarian failure.
IV. Symptoms
Symptoms of POFs is similar to symptoms of menopause, include
1. Irregular periods (different length of bleeding or change in flow)
2. Hot flashes caused by low levels of estrogen.
3. Night sweats caused by low levels pf estrogen
4. Decrease in sexual drive caused by low levels of testosterone
5. Irritability caused by low levels of estrogen
6. Painful sex caused by thinning and drying of vagina
V. Treatments
1. Estrogen therapy
a) How it works
Estrogen therapy (ET) is a medical treatment with a medication containing only estrogen hormone. Estrogen-only therapy helps to increase the estrogen levels, thereby, stimulating the communication of the brain as the increaseing of FSH hormone to induce egg production and egg extruding. It is said that Estrogen therapy has helped many women with POF to conceive.
b) Risks
i) Heart diseases
ii) Blood clotting
iii) Breast cancer
iv) Gallbladder diseases
c) Side effects
Some women may experience the below side effects
i) Fluid retention,
ii) Bloating,
iii) Nausea,
iv) Breast tenderness
v) Mood swings
vi) Headache
2. Estradiol
a) How is works
Estradiol is actually a type of estrogen, by injecting the synthesis form of estradiol , it stimulates the brain to shut off the production of FSH leading to egg maturing and extruding into Fallopian tube for natural fertilzation.
b) Risks
i) Endometrial hyperplasia
ii) Cancer of the lining of the uterus
iii) Stroke
iv) Breast cancer
c) Side effects
i)Uterine bleeding,
ii) Breast tenderness,
iii) Nausea and vomiting,
iv) Chloasma,
v) Cholestasis,
vi) Migraine headaches
3. Hormone replacement therapy HRT
a) How HRT works
Hormone replacement therapy provides estrogen and other synthesis hormones which are necessary for the natural process of menstrual cycle, by signalling the production of LH and FSH as well as signalling the release of mature egg to the Fallopian tube.
b) Risks
i) Liver disease
ii) Breast cancer
iii) Uterus cancer
iv) Blood clots in the vein, legs, or lungs
v) Gallbladder disease
vi) Heart diseases or stroke
c) Side effects
i) Vaginal bleeding of unknown cause
ii) Breast pain
iii) Nausea
iv) Bloating and fluid retention
v) Blood clots in the vein, legs, or lungs.
vi) Moodswing
4. Clomid (Clomiphene citrate)
a) How it works
Clomid stimulates the pituitary gland in secreting, leading to maturing of some eggs and ovulation.
b) Risks
i) Ovarian hyperstimulation
ii) Multiple birth
iii) Cancer
c) Side effects
i ) Hot Flashes
ii) Bloating
iii) Abdominal paid and cramps
iv) Weight gain
v) Moodswing
vi) Nausea and dizziness
vii) Abnormal menstrual bleeding
viii) Visual disturbances
6. Cytoplasm
This is a new kind of treatment, by taking DNA from your healthy egg and places it inside the nutrient components of a donor's egg as your DNA goes into the healthy egg for artificial insemination.
7. Artificial Insemination
Some doctors also try to use IVF with donor egg, while it gives the woman a baby but it dose not address the underline failure of the ovaries and other symptoms of menopause.
Unfortunately, the success rate for a happy conception for women with premature ovarian failure is about 5%.
Always keep yourself positive and work together with your doctor, you may get pregnant sooner than you think:
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Thursday, September 17, 2009
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