#ATGPremature #Ovarian #Failure (POF)
#Overview 
1 ♧● What is Premature Ovarian Failure?
This refers to a loss of normal function of the ovaries before age 40. Normally the ovaries release the eggs monthly, so if the ovaries fail, they don’t produce normal amounts of the hormone estrogen or release eggs regularly and infertility is a common result.

Premature ovarian failure is sometimes wrongly referred to as premature menopause; however the two conditions aren’t exactly the same.
 Women with premature ovarian failure may have irregular or occasional periods for years and may even become pregnant, whereas women with premature menopause stop having periods and can’t become pregnant.

The key is to restore estrogen levels in women with premature ovarian failure and help prevent some complications, such as osteoporosis, but infertility which is the ultimate result is harder to treat in this class of women.
2♧● #What are the Signs and symptoms of premature ovarian failure (POF)?
 Expectedly these are similar to those experienced by a woman going through menopause and are typical of estrogen deficiency.
They may include:
1. Irregular or skipped periods (amenorrhea), which may be present for years or may develop after a pregnancy or after stopping birth control pills
2. Hot flashes
3. Night sweats
4. Vaginal dryness
5. Irritability or difficulty concentrating
6. Decreased sexual desire
3 ♧● #What are the causes?
Normally in women with normal ovarian function, the pituitary gland ( a special organ in the brain) 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. (THIS IS THE NORMAL OVUALTION/FERRILIZATION PROCESS)
Premature ovarian failure results from one of two processes:
1☆☆●Follicle depletion: Chromosomal defects, Certain genetic disorders, toxins from Chemotherapy (cancer treatment) and radiation therapy are the most common causes of toxin-induced ovarian failure. 
These therapies may damage the genetic material in cells. Cigarette smoke, chemicals, pesticides and viruses may hasten ovarian failure.
2☆☆●Follicle disruption: An immune system response to ovarian tissue and might be unknown.
4 ♧● #Risk factors
Factors that increase your risk of developing premature ovarian failure include:
1.Age. The risk of ovarian failure rises sharply between age 35 and age 40.
2. Family history. Having a family history of premature ovarian failure increases your risk of developing this disorder.
5 ♧♧● #Complications of premature ovarian failure include:
1.Infertility. Inability to get pregnant may be the most troubling complication of premature ovarian failure, although in rare cases, pregnancy is possible.
2. 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.
3. Depression or anxiety. The risk of infertility and other complications arising from low estrogen levels may cause some women to become depressed or anxious.
6 ♧♧●#Tests and diagnosis
To make a diagnosis of premature ovarian failure, your doctor may ask about your signs and symptoms, your menstrual cycle, and a history of exposure to any toxins, such as chemotherapy or radiation therapy, which cause direct injury to follicles and eggs. 

Most women have few signs of premature ovarian failure, but you’ll likely have a physical exam, including a pelvic exam.

Your doctor may also recommend one or more of these tests:
1. Pregnancy test. This test checks for the possibility of an unexpected pregnancy in a woman of childbearing age who has missed a period.
2. Follicle-stimulating hormone (FSH) test. FSH is a hormone released by the pituitary gland that stimulates the growth of follicles in your ovaries. Women with premature ovarian failure often have abnormally high levels of FSH in the blood.
3. Estradiol test. The blood level of estradiol, a type of estrogen, is usually low in women with premature ovarian failure.
4. Prolactin test. High levels of prolactin — the hormone that stimulates breast milk production — in your blood can lead to problems with ovulation.
 
6 ♧♧●#Treatments and drugs
Treatment for premature ovarian failure usually focuses on the problems that arise from estrogen deficiency.
This may include:
1. Estrogen therapy. To help prevent osteoporosis and relieve hot flashes and other symptoms of estrogen deficiency, your doctor may recommend estrogen therapy to compensate for the estrogen your ovaries no longer produce.
2. Calcium and vitamin D supplements. Both calcium and vitamin D are important for preventing osteoporosis. If you don’t get enough of them through your diet, your doctor may recommend supplements
3. Addressing infertility
Infertility is a common complication of premature ovarian failure. There’s no treatment proved to restore fertility in women with this condition. It’s important to understand and grieve for this loss of ovarian function and to seek counseling if you need it.
Some women and their partners choose to pursue a pregnancy through in vitro fertilization using donor eggs. 
#References. 
Mayo Clinics 
#TeamAsktheGynaecologist
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~~ Dr Chudi Godsons


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