Life is a paradox. It is full of surprises, yet we never expect the unexpected. During our life cycle, there are certain medical conditions that we mentally gear up to, like natural menopause in women. There is access to plethora of information that make coping with the condition far easier. And then there are a few other disorders that we never expect to have – like Premature Ovarian Failure. Lack of suitable information, an overwhelming sense of grief and other painful emotions associated with its diagnosis can create havoc in a young woman’s life.
The biggest trauma caused during POF is due to infertility. POF is defined as the cessation of normal functioning of ovaries in women less than 40 years and affects nearly 1-4% of the female population. Normally, a woman releases one egg during each menstrual cycle from puberty till the age of 50. Normally, the ovaries have enough eggs to last an entire reproductive cycle, after which menopause occurs. POF on the other hand is not a natural occurrence and can happen as early as teen years.
Are POF and Early Menopause Synonymous?
Earlier, health care providers used the term early or premature menopause to describe POF but this is no longer appropriate. Women who have attained menopause will rarely ever have a period again but those with POF have periods, although irregular. Moreover, menopausal women can never again conceive naturally, but this is still a possibility with POF.
Why Does This Happen?
Ovaries are made up of tiny, fluid filled sacs called follicles, which contain eggs. A normal woman is born with about 2 million follicles which mature during each menstrual cycle and release one egg into the uterus. In POF, this mechanism is disturbed due to the following reasons:
A woman with this condition does not have enough follicles and therefore insufficient eggs to last through a reproductive cycle. Follicle depletion can be a result of:
- Exposure to radiation or chemotherapy for cancer
- An abnormal or missing “X” chromosome
Rarely, there may be a sporadic function of follicles leading to ovulation and an irregular menstrual cycle. If insemination occurs, this could lead to pregnancy as well, although this is a very uncommon situation.
This is different from follicle depletion in the sense that a good number of follicles may be present, but they fail to function properly. This condition is generally a result of an autoimmune disorder which causes the body to attack its own developing follicles.
Although researchers lack clarity on the actual cause, a few metabolic and endocrine defects may indicate POF.
Like blood pressure, regular periods are an indicator of good health in women and any irregularity is the most obvious indication. Some women experience other symptoms as well such as:
- Hot flashes or night sweats
- Vaginal dryness
- Decreased interest in sex
- Painful intercourse
The condition is further confirmed by performing a blood test to check levels of a hormone- follicle stimulating hormone (FSH), a high level indicating POF.
Hormone Replacement Therapy (HRT) and POF
The most common form of treatment recommended to treat this condition is HRT. During POF, the body does not maintain the right levels of hormones required for normal functioning. HRT makes up for this deficit, thus restoring a woman’s chances of having regular periods. Oestrogen is responsible for bone health and low LDL cholesterol in women and therefore HRT reduces the risk of osteoporosis and heart disease associated with POF.
The only mantra to keep most diseases at bay naturally is- “Keep fit, follow a healthy diet and reduce stress”. Hormones are chemical messengers which impact the overall health of an individual. Balancing hormones is therefore very important and can be achieved naturally by supplementing diet with the right nutrients and releasing stress through either a physical workout or meditation.
POF and Pregnancy
Diagnosis of POF can have devastating effects on those who wish to conceive. But what one must understand is that “Failure” does not mean complete stoppage of ovarian function, but only an abnormality. Failure can also be temporary or periodic and there can be residual ovarian function, thus allowing intermittent ovulation in women with POF.
5-10% of women conceive naturally despite being diagnosed, or after initiating HRT. But for those who haven’t, egg donation through in-vitro fertilisation gives the opportunity to reproduce. For most women, half the battle is won once they find an experienced physician who can tend to their endocrine, reproductive and emotional needs. There are specialists qualified in reproductive endocrinology who receive additional training on POF diagnosis and treatment.
Getting a grip over one’s life after diagnosis can be challenging, but taking the right nutritional supplements to boost hormone balance, preventing other associated health risks and support from your partner and family are adequate measures to regain happiness.
Written by Snigdha Taduri