Signs and symptoms of premature ovarian failure are similar to those experienced by a woman going through menopause and are typical of estrogen deficiency. They include:
- Irregular or skipped periods (amenorrhea), which may be present for years or may develop after a pregnancy or after stopping birth control pills
- Hot flashes
- Night sweats
- Vaginal dryness
- Irritability or difficulty concentrating
- Decreased sexual desire
When to see a doctor
If you notice that you've skipped your period for three months or more, see your doctor to help determine what may be the cause. You may miss your period for a number of reasons — including pregnancy, stress, or a change in diet or exercise habits — but it's best to get evaluated whenever your menstrual cycle changes.
Even if you don't mind that your periods have stopped, it's still wise to see your doctor and try to find out what's causing the problem. If your estrogen levels are low, bone loss can occur.
In women with normal ovarian function, the pituitary gland releases certain hormones during the menstrual cycle, which causes a small number of egg-containing follicles in the ovaries to begin maturing. Usually, only one follicle — a sac that's filled with fluid — reaches maturity each month.
When the follicle is mature, it bursts open, releasing the egg. The egg then enters the fallopian tube where a sperm cell might fertilize it, resulting in pregnancy.
Premature ovarian failure results from one of two processes — follicle depletion or follicle disruption.
Causes of follicle depletion include:
- Chromosomal defects. Certain genetic disorders are associated with premature ovarian failure. These include Turner's syndrome, a condition in which a woman has only one X chromosome instead of the usual two, and fragile X syndrome, a major cause of intellectual disability (intellectual development disorder), formerly called mental retardation.
- Toxins. Chemotherapy and radiation therapy are the most common causes of toxin-induced ovarian failure. These therapies may damage the genetic material in cells. Other toxins such as cigarette smoke, chemicals, pesticides and viruses may hasten ovarian failure.
Follicle dysfunction may be the result of:
- An immune system response to ovarian tissue (autoimmune disease). Your immune system may produce antibodies against your own ovarian tissue, harming the egg-containing follicles and damaging the egg. What triggers the immune response is unclear, but exposure to a virus is one possibility.
- Unknown factors. If you develop premature ovarian failure through follicular dysfunction and your tests indicate that you don't have an autoimmune disease, further diagnostic studies may be necessary. An exact underlying cause often remains unknown.
Factors that increase your risk of developing premature ovarian failure include:
- Age. The risk of ovarian failure rises sharply between age 35 and age 40.
- Family history. Having a family history of premature ovarian failure increases your risk of developing this disorder.
Complications of premature ovarian failure include:
- Infertility. Inability to get pregnant may be the most troubling complication of premature ovarian failure, although in rare cases, pregnancy is possible.
- Osteoporosis. The hormone estrogen helps maintain strong bones. Women with low levels of estrogen have an increased risk of developing weak and brittle bones (osteoporosis), which are more likely to break than healthy bones.
- Depression or anxiety. The risk of infertility and other complications arising from low estrogen levels may cause some women to become depressed or anxious.