Premature ovarian insufficiency

A condition characterised by the fact that the ovaries stop producing oestrogen and releasing eggs periodically, before a woman reaches the age of 40. Unlike early menopause, in the case of early ovarian failure, women may menstruate occasionally for years, with the possibility of even becoming pregnant.

Possible causes include genetic alterations, either due to an alteration of an X chromosome from birth, or due to toxicity from chemotherapy, radiotherapy or tobacco smoke. Less frequently, the alteration may be due to an autoimmune disease that attacks the ovarian tissue. 

It manifests with irregular menstrual periods and difficulty in becoming pregnant. It may also be accompanied by menopausal-like symptoms such as hot flushes, night sweats, mood swings, decreased sexual desire and problems with concentration and/or memory. 

It is diagnosed by means of a directed medical history and a physical examination with gynaecological and pelvic examination. It is completed by laboratory tests including hormone levels such as follicle stimulating hormone, oestradiol and prolactin. When a genetic origin is suspected, a karyotype study will be necessary to identify changes in the chromosomes. 

Treatment is based on replenishing the deficient oestrogen levels; it is often accompanied by progesterone supplementation to prevent uterine diseases. As a side effect of falling oestrogen levels is the development of osteoporosis, vitamin D and calcium supplements are also administered.

Early ovarian failure has been linked to the development of other diseases: infertility; osteoporosis; depression and/or anxiety; cardiovascular disease; dementia and Parkinson's disease.