What happens differently in premature ovarian failure?
Currently, researchers are unable to pinpoint
exactly what happens in premature ovarian failure to stop normal function of the ovaries in most
cases. Remember that the FSH levels are high when the ovaries fail to produce
enough estrogen. LH levels also stay high in many cases, even during the
occasional times that follicles successfully grow. Mature follicles in the
ovaries make estrogen, as well as other substances, including the protein
inhibin. Because women with premature ovarian failure have low
levels of estrogen, scientists are focusing their attention on the follicles in
the ovary in their study of premature ovarian failure.
Follicles in the ovaries start out as microscopic seeds, called primordial
(pronounced prime-OR-dee-ul) follicles. These seeds are not yet follicles, but
can grow into them. In general, a woman is born with about two million
primordial follicles, which should be enough to last her until she goes through
menopause. But this may not be the case for a woman with premature ovarian
failure. Women with premature ovarian failure may
fall into one of two groups.
Follicle Depletion
A woman with follicle depletion has no responsive follicles left in her
ovaries. There is no way for the body to make more primordial follicles. And,
currently, there is no way for scientists to make primordial follicles. Although
scientists haven't identified all the causes of follicle depletion, some known
causes include:
An abnormal or missing X chromosome - the
X chromosome stores
genetic material that
helps "build" a person. It also helps to determine whether a person is a male or
a female. Females need two normal X chromosomes to make enough primordial
follicles, and to use them properly. If a critical part of either X chromosome
is missing, or if an entire X chromosome is missing, the body may not
make enough primordial follicles to begin with, or it may use them up too
quickly. This problem is the cause of premature ovarian failure in 2 percent to 3 percent of women
with the condition.
Even when it appears that all a woman's follicles are depleted, it is
possible that a very small number of surviving follicles can, without warning,
begin to function on their own. This spontaneous function can cause ovulation or
a menstrual period; if insemination occurs, this function could lead to
pregnancy, although such a situation is uncommon. Currently, health care
providers can't predict which women with premature ovarian failure will experience this recovery of
ovarian function.
Follicle Dysfunction
A woman with follicle dysfunction still has follicles in her ovaries,
but for unknown reasons they are not working properly. Currently, scientists do
not have a safe and effective way to make follicles start working normally
again. Although they have yet to identify all the causes of follicle
dysfunction, some known causes include:
An autoimmune attack - the immune system normally protects the body from
invading bacteria and
viruses. In some women,
though, for reasons researchers don't understand, the immune system attacks developing follicles, which prevents
the follicles from working the way they should. Current research suggests that
this type of problem occurs in 5 percent of women with premature ovarian
failure.
A low number of follicles - even though only one mature follicle releases an
egg each month, that follicle usually has less mature follicles developing along
with it. Scientists don't understand exactly how, but these supporting follicles
seem to play a role in helping the mature follicle function normally. If these
extra follicles are missing, the dominant follicle becomes luteinized and will
not mature and release an egg properly. Current research estimates that this
problem may occur in up to 60 percent of women with premature ovarian failure, but this is not a
definite number.
Research also shows that 10 percent to 20 percent of women with premature
ovarian failure have a
family history of the condition, which could mean that some cases of
premature ovarian failure have a
genetic component. But, inheritance patterns show that
premature ovarian failure is not a purely
genetic disorder. Research into the causes of premature ovarian failure is ongoing, in hopes that
knowing why it occurs will also help in developing treatments for the disorder.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Low testosterone can affect both men and women. Causes of low testosterone in males include undescended testicles and injury to the scrotum. Low testosterone in females includes ovary conditions. Treatment for low testosterone in men includes testosterone replacement therapy. Currently there is no FDA approved testosterone treatment for women.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Addison disease is a hormonal (endocrine) disorder involving destruction of the adrenal glands (small glands adjacent to the kidneys). Diseased glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary for normal daily body functions. Symptoms include weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin. Treatment of Addison disease involves replacing, or substituting, the hormones that the adrenal glands are not making.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause. Hot flashes can be caused by other conditions. Diagnosis is made by taking a patient history and at times, blood tests. Treatment options include hormone therapy, bioidentical hormone therapy, and medications. There are non-FDA approved natural remedies.
Infertility is the diminished ability to conceive a child. The primary cause of infertility in men is a sperm disorder. In women, the primary cause of infertility is an ovulation disorder. Most forms of infertility can be treated. Conventional infertility therapies include drugs or surgery.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Premature menopause is when a woman goes through menopause before the age of 40 because of genetics, illness, or a medical procedure. Symptoms of premature menopause include irregular or missed periods, mood swings, hot flashes, periods that are heavier or lighter than usual, vaginal dryness, bladder irritability, incontinence, dry skin, eyes or mouth, sleeplessness, and decreased sex drive. Though premature menopause cannot be reversed, the symptoms can be managed with methods similar to those used for natural menopause.
Trying to get conceive, or become pregnant can be challenging, frustrating, and an emotional rollercoaster for some couples. There are things you can do to chart progress, which may ultimately lead to a successful healthy pregnancy, or, when necessary, lead to discussions with a fertility specialist. Being aware of your menstrual cycle, charting your fertility pattern, knowing the reasons for infertility, and treating infertility are key points to discuss with your partner and physician.
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