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In this Article

• What is premature ovarian failure (POF)?
• What causes premature ovarian failure?
• What happens differently in premature ovarian failure?
• How many women have premature ovarian failure?
• What are the symptoms of premature ovarian failure?
• How do I know if I have premature ovarian failure?
• Are there treatments for the symptoms of premature ovarian failure?
• Is HRT safe for me to take if I have premature ovarian failure?
• How will having premature ovarian failure affect my overall health?
• Does having premature ovarian failure mean that I'll be infertile or unable to have children?
• What are researchers doing to learn more about premature ovarian failure?
• Where can I go for more information about premature ovarian failure?
• Find a local Obstetrician-Gynecologist in your town
• Premature Ovarian Failure (POF) Index

Because of lower hormone levels that result from premature ovarian failure, you are at greater risk for a number of health conditions. These conditions, and what you can do to stay healthy, are described below.

Osteoporosis

• Osteoporosis (pronounced OWS-tee-oh-pour-oh-siss) is a bone disorder that decreases bone strength and increases the risk for breaks and fractures.
  
  
• Estrogen helps to conserve calcium and other minerals in bones and protects against bone loss. In premature ovarian failure, the ovaries stop making estrogen, which can cause women to lose bone density, or bone strength, one of the major factors leading to osteoporosis.
  
  
• Even though osteoporosis is more common in people ages 50 and above, women with premature ovarian failure may experience the condition at a much younger age.

Are there ways to prevent or treat bone conditions in women with premature ovarian failure?

To protect against bone loss, the National Osteoporosis Foundation recommends that women who are at risk for osteoporosis:

• Get at least 1200 mg of calcium in their diets every day. If it is not possible to get this amount through diet, take a calcium supplement.
  
  
• Get between 400 IU and 800 IU of vitamin D, which helps the body absorb calcium, every day.
  
  
• Get regular, weight-bearing and muscle-building physical activity. Weight-bearing physical activity, such as walking, will help build bone strength. Activities like yoga or tai chi help build muscle strength and improve flexibility.

An adequate level of estrogen in the body is an important factor in preventing bone loss that may lead to osteoporosis. The strategies listed here may slow bone loss, but none of them will prevent bone loss entirely.

Low thyroid function

• This problem is also called hypothyroidism (pronounced high-poe-THIGH-royd-iz-em).
  
  
• The thyroid is a gland, like the ovary, adrenal, and pituitary glands. It makes and releases hormones. Specifically, the thyroid makes hormones that control the body's metabolism and energy level. Low levels of the hormones made by the thyroid can affect metabolism, and can cause a woman to have very low energy.
  
  
• Symptoms include a slow down in the body's normal rate of functioning, which can lead to mental and physical sluggishness. Cold feet are also a feature of low thyroid function.
  
  
• A study found that 27.0 percent of women with premature ovarian failure also had low thyroid function. In the general population, only two percent of all people (both men and women) have low thyroid function.

Are there ways to prevent or treat low thyroid function in women with premature ovarian failure?

Replacing the hormone that the thyroid is not making enough of treats this problem. Usually, you can take a pill to replace the hormone.

Addison's disease

• Addison's disease is an autoimmune disorder, meaning the body's immune cells, which normally protect the body from invading cells and microbes, attack the adrenal glands, part of the endocrine system located above the kidneys. The adrenal glands produce hormones that regulate the body's response to stress and its handling of salt.
  
  
• Addison's disease is also called primary autoimmune adrenal insufficiency.
  
  
• Studies suggest that 3.2 percent of women with premature ovarian failure also have Addison's disease, making them much more likely than members of the general population to develop the disease.
  
  
• Symptoms of Addison's disease include loss of appetite, weight loss, dizziness when standing, and fatigue. In later stages of Addison's disease, salt craving, low blood pressure, and darkening of the skin may occur.
  
  
• Research indicates that an adrenal antibody test is the most effective way to detect Addison's disease in women with premature ovarian failure. If the results of this test are positive, a health care provider may order a second test, called an ACTH stimulation test, to confirm the diagnosis. Both tests involve collecting blood samples.

Are there ways to prevent or treat Addison's disease in women with premature ovarian failure?

While there is currently no way to prevent Addison's disease, the best way to treat it is to find out whether you have it. You can easily manage the condition with the help of your health care provider, by taking medication that replaces the hormones your adrenal glands are not making. If left untreated, however, the disease can be life threatening because the body can't respond properly to stressful events, such as severe illness, injury, or surgery.

Researchers now recommend that health care providers screen all women who have confirmed premature ovarian failure for Addison's disease using the adrenal antibody test, although such screening is not yet standard practice. If women with undetected Addison's disease undergo an exceptional physical stress, such as surgery or a car accident, they are at risk for an "adrenal crisis," a situation that can lead to shock and even death. Therefore, screening for the disease is especially important before a woman with premature ovarian failure has surgery or undergoes other known physical stresses.

Heart disease

• While it is very rare for a young woman with premature ovarian failure to develop heart disease, certain factors related to the disorder might increase her chances of developing heart disease later in life.
  
  
• Lower levels of estrogen in premature ovarian failure can lead to higher levels of low-density lipoprotein (LDL) cholesterol. LDL is known as "bad" cholesterol because it is the main source of the buildup and blockage in arteries that can lead to heart attacks.
  
  
• Lower levels of estrogen in premature ovarian failure can also lead to lower levels of high-density lipoprotein (HDL) cholesterol, known as "good" cholesterol because it helps prevent buildup and blockage in the arteries.
  
  
• After some time, buildup of cholesterol in the arteries can cause "hardening of the arteries," which means that the blood flow to the heart is slowed down or blocked. Blood carries oxygen to the heart. If the heart can't get enough oxygen, a person may have chest pain. If the blood supply to part of the heart is cut off completely, because of blockage, the result is a heart attack.

Are there ways to prevent heart disease in women with premature ovarian failure?

Getting adequate estrogen therapy may help guard against heart disease. Estrogen helps the body by:

• Keeping the lining of the arteries healthy
  
  
• Relaxing muscles that control arteries to allow better blood flow to tissues
  
  
• Normalizing LDL and HDL levels to decrease cholesterol build up in the arteries that could lead to blockage Maintaining a healthy body weight and getting regular physical activity are important in reducing the risk of heart disease. These factors can affect your cholesterol level, which, in turn, can affect your risk for heart disease. Other risk factors for heart disease include:
  
  
• Cigarette smoking
  
  
• High blood pressure (defined as 140/90 mm/Hg or higher, or being on blood pressure medication)
  
  
• High blood cholesterol
  
  
• Family history of heart disease
  
  
• Age: women—55 years or older

Talk to your health care provider about heart disease to determine what steps, if any, you should take to lower your risk.

• Among women with premature ovarian failure, studies show that 13.8 percent of women with a family history of premature ovarian failure, and 2.1 percent of women without a family history of premature ovarian failure may also have a mild form of Fragile X syndrome.
  
  
• Fragile X syndrome is a genetic condition that arises because of an error in a single gene. In women with an affected gene, the symptoms can range from none at all, to learning disabilities and problems with math, to a slightly higher risk of anxiety disorder. Women who have an affected gene may pass it on to their children, who may experience learning disabilities and other problems as a result.
  
  
• If you have a confirmed diagnosis of premature ovarian failure, you should talk to your health care provider about Fragile X syndrome and tests to find abnormalities in the Fragile X gene.