Premature ovarian failure (POF), or early menopause is defined as the loss of ovarian function before age 40. This is different from the normal and natural menopause process that all women go through. In the case of premature ovarian failure or early menopause, there are often small primordial follicles remaining in the ovary, and there is a chance of conceiving naturally (albeit a small chance) or of having irregular periods. Women with POF or early menopause will have high FSH, low estrogen, and amenorrhea or no menstrual periods. In many cases, POF can begin in women in their 20s, and it affects on average 1% of women overall.
Early Menopause or POF | What is the cause?
- autoimmune disease, including celiac disease and autoimmune thyroid disease
- radiation or chemotherapy for cancer
- pelvic surgery
- genetic disorders such as turner’s syndrome or fragile x syndrome
Early Menopause Symptoms include
- high FSH
- low estrogen/ low estradiol
- amenorrhea or missing menstrual periods
- hot flashes
- night sweats
- vaginal dryness
- osteopoenia or a reduction in bone density
Am I really in menopause?
Early menopause or premature ovarian failure must be differentiated from a condition which looks very similar, premature ovarian aging(POA). Women with premature ovarian ageing have a better chance of achieving pregnancy with treatment. As premature ovarian aging patients also have high FSH, and loss of regular menstrual periods, it can be difficult to distinguish between these two disorders without the proper testing. As a diagnosis of POF is a highly emotional and stressful event, it is crucial to determine which of these disorders is actually present.
Variants of POF
In some cases of POF, autoimmune disease may attack the more developed follicles and may leave the smaller undeveloped primordial follicles untouched. In these cases, there may be ways to lower the autoimmune process and improve the condition. In other cases of POF, FSH may bind to the follicles in an attempt to cause them to mature, but the FSH produced by the pituitary gland may be inactive. In this case as well, there is an opportunity to treat the condition by working to lower FSH and then stimulating the maturation of the primordial follicles. In POF it is extremely important to do a serum Antimullerian Hormone(AMH) which can help to determine the status of the primordial follicles remaining in the ovary.
According to research, naturopathic medicine may be helpful for premature ovarian failure. Certain combinations of supplements for POF , POA or early menopause may improve symptoms or chances of conceiving, including androgens such as DHEA, and mitochondrial antioxidant therapies.
There are increased risks for specific conditions in women who are suffering from early menopause or POF which are:
- cardiovascular disease
- symptoms of estrogen and testosterone deficiency including hot flashes, loss of libido, vaginal dryness, and mood changes
Many of these can be managed with naturopathic preventative treatment including either hormonal therapies and/or supplements and nutrition.