Premature Ovarian Failure
Premature ovarian failure (POF) is defined as the cessation of menses associated with high levels of gonadotropins and low levels of estrogen before age 40. The condition has also been termed “premature menopause” or “precocious menopause.” The frequency of the condition is related to the age at diagnosis. At age 30 approximately 1:1000 patients will be affected, by age 40 approximately 1:100 will be affected. Thus, this is a relatively common condition.
Prior to the onset of amenorrhea, a woman may have regular monthly menses, several months of an irregular bleeding pattern, or intermittent symptoms of irregularity. The amenorrhea may also be preceded by use of a hormonal contraceptive agent or by pregnancy. There is no evidence that either hormonal contraception or pregnancy increases the risk of POF. There may be associated complaints of hypoestrogenism, including vasomotor symptoms, vaginal dryness and dyspareunia.
POF was initially believed to be an irreversible condition, but is now known that ovarian failure is often intermittent, especially in chromosomally normal women. Case series have reported up to a 60% rate of subsequent ovarian function.
In the mid 1980′s, Carolyn Coulam, M.D. published an article called Incidence of Premature Ovarian Failure, which has since remained the standard by which researchers determined the incidence rate of POF. The study followed women who lived in Rochester, Minnesota, were seen for medical care at the Mayo Clinic, and who were born around 1930. Their records were followed from 1950 through 1986 for the age at which natural menopause occurred. The study concluded that natural menopause before age 40 is unusual — the incident rate in the 40 to 44 age group was more than 10 times larger than in the 30 to 39 year age group.
No known therapy for patients with premature ovarian failure has been proven effective. Different research articles and reports have suggested that high-dose, long-term prednisone therapy may be useful in treating autoimmune ovarian failure.
However, prednisone, when used in high-dose for a long-term has substantial side effects, including aseptic necrosis of bone requiring major surgical intervention. Despite this risk, patients with premature ovarian failure are being treated based on this anecdotal evidence.
The best source of information as well as support I found was The Premature Ovarian Failure Support Group at www.pofsupport.org.