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If you have been diagnosed with POF, you must feel alone and confused. It might help you to know that there are thousands of other young women who must deal with the same problem too: POF namely affects 1 out of 1000 women between age 15 and 29.
The number is even higher for age group 30 to 39: 1 out of 100 women suffer from POF. The average age of onset of POF is 27 years, but it has been diagnosed in girls as young as 14.     
In this article we will explain symptoms and consequences of premature ovarian failure, referred later in article as POF, or also known as early menopause. This article was created to help answer your questions about POF, or as some health care providers describe this condition: primary ovarian insufficiency.

What is premature ovarian failure?

Premature ovarian failure (POF) is term that describes a stop in normal functioning of the ovaries in woman under the age of 40. Naturally, many women experience decline in fertility around late 40s or early 50s: this age usually marks the beginning of the onset of menopause. Menopause does not happen overnight: it starts with irregularities in menstrual cycles and this may take several years before 'definite' menopause occurs.  
In the past, health care providers called premature ovarian condition premature menopause, but this is not very accurate description of what happens with women with POF. For example, woman who has gone through menopause has no chance of getting pregnant naturally, while woman with POF can still get pregnant. There are some other differences, but we will get back to them later in this article.

Symptoms of POF

The two most common physical symptoms of POF among adolescent women are lack of breast development and lack of menstrual periods.

Most common physical symptoms of POF:
  • lack of breast development during puberty or decrease in breast size
  • lack of menstrual periods
  • vaginal dryness
  • hot flashes
  • mood swings
  • insomnia

Most common psychical symptoms of POF:
  • depression
  • anger
  • sadness
  • feelings of loss

Is premature ovarian failure the same as early menopause?

As briefly mentioned early in article: no, it is not. Although the symptoms are very similar and POF also was once considered to be a form of early menopause.  
There are differences in two conditions:
menopuse occurs as result of aging (results as follicle depletion)
with POF  up to 50% of patients may ovulate once in any given year and 5-10% may become pregnant, therefore POF is better understood as follicular dysfunction rather than complete ovarian failure

POF diagnose

POF is diagnosed by blood test to check the hormone level- FSH. In women with POF, FSH (Follicle Stimulating Hormone) is high. This is because women with POF do not produce enough (or right) amounts of estrogen (this is consequence of not having period). Because of low amounts of estrogen, pituitary gland in the brain starts releasing hormone called the follicle-stimulating hormone (FSH). This hormone sends a signal to the ovaries telling them to start making estrogen. If your ovaries are 'healthy', they will do so, but if you have POF, your ovaries cannot make estrogen, so the amount of FSH in your blood stays high. Hence the correlation between POF and high levels of FSH.  

POF treatment

POF is a condition that is usually permanent, but it can be unpredictable, and unfortunately, at this time there are no medical tests that can tell for sure whether your POF condition will be premanent or not.
POF treatment is called hormone replacement therapy (or HRT), because hormones that are necessary for menstrual periods, breast development and healthy bones need to be replaced. The hormones that need to be replaced are estrogen, progesterone, or both.
HRT is available as pills, birth control pills, which also contain estrogen and progesterone, skin patches, shots and vaginal rings. Pills or skin patches are usually the easiest form of HRT to take.
Besides taking detailed clinical histories and performing careful physical evaluations, and undergoing hormone replacement treatment, women with POF should also undergo serum calcium, phosphate and protein determination. This determinations are done for the exclusion of often associated thyroid disease and thyroid antibody determination. 
Some women, on the other hand do not want to take pills or injections, or only use them for a short time. If you are one of them, there are other options available. For example, if you have problems with osteoporosis, there are drugs that are used to prevent it or treat it. If vaginal dryness is your concern, use lubricants that can be helpful. However, consult with your doctor what you can do (besides HRT) to manage your POF symptoms.

Read More: Ovarian cancer: Causes, symptoms risk factors, treatment and prevention


Fertility issues

Many women with POF, especially those who face it as early as their 20s and 30s have not had the chance to make a decision about having children and find that opportunity denied to them. This can be a shattering experience! 
However, 50% of women with POF may ovulate once in any given year and 5-10% may become pregnant! We don't want to raise false hope, but everything is possible. And if the natural way fails, there are many other options if you want to become mother one day.
Women with POF have available fertility treatment if they want to have a baby! First, you should talk to your gynecologist or reproductive endocrinologist can talk to you about this issue and then you'll be given advice based on your specific situation.  
One option is called 'In-Vitro Fertilization' (IVF) with donor eggs. IVF is a procedure that involves removing another woman's egg from her ovary, fertilizing it with your partner's sperm, and putting that fertilized egg into your uterus. Then you carry and give birth to the baby. The success rate of the procedure depends on many factors, thus it is important to discuss this with a fertility expert whenever you feel ready to have children.
Another option is adoption. There are many children who need a home and are adopted by couples who can't have their own children.