What is Premature Ovarian Syndrome?


Premature Ovarian Syndrome is known in the medical field as primary or premature ovarian insufficiency (POI). This term encompasses the spectrum of conditions attributed to suboptimal ovarian function that usually leads to early menopause. Somewhere between 0.5% and 3% of people with ovaries who are under the age of 40 will experience POI and most won’t be diagnosed until fairly late stages of the syndrome.

It’s nearly impossible to keep track of all the symptoms and possible diagnoses that are going on in our bodies. With POI, the symptoms could be caused by something else entirely (which is why it’s always important to consult your doctor). However, we wanted to give you some insight into what we’ve learned about POI so you can have a more productive conversation with your doctor.

What to look out for:
Though early stages of POI can be asymptomatic, there are a few symptoms and risk factors to look out for, most commonly irregular or absent menstruation. Other symptoms include difficulty getting pregnant, menopause-like hot flashes and night sweats, lowered libido, irritability, anxiety, and depression. In adolescents the symptoms of POI can also include undeveloped breasts during puberty. People with autoimmune or metabolic disorders, like Hashimoto’s disease, have an increased risk of developing POI.

What’s happening in bodies with POI?
POI results in lowered levels of female sex hormones, especially estrogen, which can have negative effects on the body. Some long-term effects are similar to those commonly experienced during menopause, such as decreased bone density and infertility, and other effects include cardiovascular health issues, mental health issues, and dementia. If left untreated, POI can contribute to the development or acceleration of these conditions.

The connection to infertility:
One of the main concerns for people with POI, and often the reason they see a doctor and are diagnosed, is trouble conceiving and the possibility of infertility. The good news is that infertility isn’t definitive when dealing with POI. Not all instances of POI result in early menopause since the condition exists on a spectrum.  Some people with POI may still get a period, even if it comes irregularly, and can potentially conceive with or without medical interventions like intrauterine insemination or in vitro fertilization.

What causes it?
Currently, so most people experiencing it won’t get a satisfying answer as to why their body started menopause early. The other approximately 10% of people who have POI can trace it back to either an autoimmune disease, exposure to toxins from chemotherapy or radiation, surgical intervention, or genetic abnormality.

Treatment options:
The standard treatment for POI symptoms is the administration of estrogen and/or progesterone replacement therapy in the form of pills, topical gels and creams, patches, or intrauterine devices. If POI is present due to autoimmune or hormonal issues, treating those conditions can sometimes help lessen POI symptoms. Some promise has also been shown in lessening the negative effects of POI with hormone replacement therapy administered via shots and vaginal suppositories rather than via the standard protocol using pills taken orally. Though the studies have used small sample sizes of women, better outcomes in bone density, cardiovascular health, and uterine health have been observed.  

As stated above, the first symptom most people experience that could lead to a diagnosis of POI is irregular menstruation. There are many reasons why someone might miss one or more period, but POI is one of the conditions that has potentially serious effects beyond loss of fertility. If you’re concerned about primary/premature ovarian insufficiency based on symptoms or risk factors, be sure to check with your doctor or other trusted health professional to get more information.

If you have been diagnosed with Premature Ovarian Syndrome and would like to share your story, please reach out to us! We’d love to hear from you. Email us at hello@gatherforwomen.com.

*NEW STUDY* 3/19/2018: Stem Cell Tx: New Hope in Premature Ovarian Failure
Stem cell therapy could help reverse premature ovarian insufficiency, researchers reported here. According to preliminary results from the ongoing ROSE clinical trial, autologous human bone marrow mesenchymal stem cells were able to aid in the reversal of hypo-estrogenemia, subsequently followed by the resumption of regular menstruation, reported Propser Igboeli, MD, of Augusta University in Georgia and colleagues, at ENDO 2018