As we know now, the women facing premature ovarian failure produce very little or negligible amounts of estrogen. Therefore, the focus of the treatment for the POF condition centers on the problems that crop up from deficiency of the estrogen hormone.
Premature ovarian failure (POF) is the result of malfunctioning of ovaries in females prior to attaining the age of 40. The females having POF are not able to release an egg every month from their ovaries. This process is known as ovulation. This functional loss may arise because of lesser quantity of follicles (the eggs are found wrapped in the follicles) or because of ovarian dysfunction.
For understanding the ovarian failure prematurely, one is required to know the ovulation process. In a nutshell, every woman is born with nearly 2 – 3 million ovarian follicles (each follicle containing an egg). As she attains puberty, she is left with only 3 – 4 lacs of these. These follicles are vital as they mature. An egg is released every month from them at the time of ovulation. Though the figure of 3 or 4 lacs appears to be a lot, but not all the follicles attain maturity to release an egg.
In the beginning of your menstrual cycle, the estrogen levels in a female body are low. Your hypothalamus, which controls the brainy hormonal levels, indicates to the pituitary gland to release follicle-stimulating-hormone (FSH).
This FSH activates the growth of follicles into mature eggs. It is worth remembering that just one follicle is lucky to attain maturity and release a mature egg. The follicles on attaining maturity release another hormone, estrogen. Estrogen indicates to the hypothalamus to discontinue generating FSH.
In case the follicles do not attain maturity and generate estrogen, the production of FSH continues to reach the high levels.
This is the reason why females having POF are examined for increased FSH levels. As the estrogen reaches the sufficiency level, both the hypothalamus and the pituitary glands come to know the availability of a mature egg and release luteinizing hormone (LH). This is known as LH surge.
Within 24 to 36 hours of the rise in LH levels, a mature egg, which is ready for fertilization, is released. In the meanwhile, the progesterone thickens the uterine lining in anticipation of the embryo implantation. In case the fertilization does not take place, the egg dissolves. After a few days, the hormone levels fall and the uterine lining starts shedding. This is referred as the onset of a new menstrual cycle.
Your treating doctor may advise:
Estrogen Hormone Therapy
POF may place you to face some complications like osteoporosis and hot flashes and other warning signs of estrogen deficiency. Your treating doctor may advise you to undergo estrogen therapy. The therapy will help you give back the required estrogen level which your ovaries are not producing ever since you are caught in the POF situation.
Estrogen hormone is generally recommended along with progesterone hormone. Including progesterone hormone with the estrogen hormone helps in protecting the uterus lining, also known as endometrial, from precancerous variations caused by the estrogen hormone, if taken without the progesterone hormone. This hormonal combo may lead to vaginal bleeding yet again. But mind it! It won’t bring back the ovarian functions to normal.
Based on the condition of your health problems and also your personal preferences, this hormonal therapy may be continued till the age of your attaining natural menopause. While the puberty begins at the age of 9 on an average, the normal age of your natural menopause is around 50 to 52.
Potential Health Risks
Calcium and vitamin D supplements
For preventing the osteoporosis, Calcium and Vitamin D are of utmost importance. Ideally, you should be regularly getting enough amounts of these through your diet. If you have not been getting adequate quantity of these nutrients through your diet, you may be prescribed to take supplements. Your treating doctor may suggest you undergo the bone density test. This test will help your treating doctor to get a fair idea of the bone mineral density measurement to make a check for any bone loss.
The National Institutes of Health of the US Department of Health and Human Services recommends 1,200 to 1,500 mg of elemental calcium intake every day to avert the effects of osteoporosis. Apart from the elemental calcium intake, the Institute advises women having POF/POI to take 1,000 International Units (IU) of Vitamin D each day to help the body absorb calcium.
Both these nutrients are vital for keeping your bones healthy.
Premature Ovarian Failure may place you facing Infertility. There is, however, no proven treatment that can bring back fertility in women facing this condition. You may consult your treating doctor and seek the support from their Clinic.
Your treating doctor may advise you to go in for in vitro fertilization and use donor eggs for achieving pregnancy. In this procedure, eggs are removed from the donor ovaries and fertilized with your partner’s sperm in a laboratory. The method is also known as test tube baby.
For sustaining your pregnancy, your doctor may prescribe medications for you that harmonize your required hormones. Once the pregnancy is confirmed, and the pregnancy progresses naturally to deliver a baby.