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No More Periods
Premature Ovarian Failure
By Lisa Hurt Kozarovich
Beth Thomason and her husband were optimistic when they began seeing a fertility specialist last year. The Greenville, S.C. couple knew they faced the possibility of ongoing tests and frustrating efforts to become pregnant, but they felt ready for the challenge. What they weren't prepared for was the devastating news that Beth had been diagnosed with premature ovarian failure or POF.
According to The International Council on Infertility Information Dissemination in Arlington, Va., POF is defined as the cessation of periods in women who are under age 40 and have elevated levels of follicle stimulating hormone (over 40 mIU/mL). However, a woman can have menstrual cycles and no other symptoms and still have POF, points out Dr. Neil Goodman, chairman of the American Association of Clinical Endocrinologists Reproductive Medicine Committee.
Intermittent POF – when a woman may have no periods and then spontaneously have one – can be even more difficult to diagnose, especially when the patient is trying to conceive. A series of simple blood tests, most notably the FSH test, can determine the diagnoses in both cases.
"It's a menopause-like syndrome," says Dr. Goodman, a clinical professor at The University of Miami School of Medicine. "At birth, women start out with a certain number of eggs, then lose them over the years. Eggs don't constantly reproduce like sperm. Patients with POF lose their eggs earlier – maybe in their 20s instead of their 50s."
Women with POF may face many of the same symptoms (like hot flashes and decreased energy) and health problems (like increased risk for heart disease and osteoporosis) as menopausal women, Dr. Goodman says. The treatment is also usually the same: hormone replacement therapy (HRT).
Though the condition hasn't gotten as much attention as other causes of infertility, it occurs in about 1 in 1,000 women ages 15 to 29 and 1 in 100 of 30- to 39-year-olds, according to The National Infertility Association.
