Premature Ovarian Failure: Symptoms and Causes

Premature ovarian failure is a condition affecting women under the age of 40 who have yet to experience menopause. This condition may lead to infertility, which may be a disheartening problem for couples who want to conceive.

doctor with a green ribbon on her palm

Motherhood is a dream for most women and may stay as one for some who suffer from premature ovarian failure. What exactly is this condition and how can it be treated? Plus, does it show any symptoms that women should be aware of?

What Is Premature Ovarian Failure?

Primary ovarian insufficiency or premature ovarian failure is a condition affecting the normal function of a woman’s ovaries who are under the age of 40 years old and have yet to go through menopause. Ovaries are tasked with producing estrogen on a regular basis. However, when it fails to do so, it may lead to infertility.

While it is sometimes linked to premature menopause, this condition is different. For women with primary ovarian insufficiency, periods are either irregular or occasional. Pregnancy may also happen. Alternatively, a woman who has premature menopause no longer have their periods and pregnancy is impossible.

Causes of Primary Ovarian Insufficiency

In normal ovarian function, hormones are released by the pituitary gland once menstruation begins. This, in turn, leads to the ripening of egg-containing follicles found in the ovaries. Matured follicles release an egg that heads into the fallopian tube. If a sperm is present at that time, then fertilization occurs and results in pregnancy.

However, for women who have primary ovarian insufficiency, there are no eggs produced. This is caused by the following:


Radiation therapy and chemotherapy cause ovarian failure that is toxin-induced. The genetic material in the cells is damaged because of these therapies. Other toxins that may cause ovarian failure are viruses, pesticides, chemicals, and cigarette smoke.

Chromosomal Defects

Genetic disorders are also linked with this condition. Some genetic disorders are fragile X syndrome, where the X chromosomes break easily due to being fragile; and mosaic Turner’s syndrome, where a woman has an altered second X chromosome and one normal X chromosome.

Autoimmune Disease

This is a rare condition where the body produces antibodies that target and destroy ovarian tissues. This leads to the egg being damaged along with the follicles.


Sometimes, the three causes initially mentioned may not be the cause of ovarian failure. This is when your attending physician requests for more tests done to find the cause. However, in some cases, the reason for this condition is still unknown.


The symptoms are similar to women experiencing menopause or those with estrogen deficiency. Some of the symptoms include the following:

Premature Ovarian Failure Symptoms
  • Amenorrhea (Skipped or Irregular Periods)
  • Diminished Sexual Desire
  • Difficulty Conceiving
  • Difficulty Concentrating
  • Dryness of Vagina
  • Hot Flashes
  • Night Sweats

When Do You See a Doctor?

For women who have missed periods for more than three months, then it is best to consult with your doctor to determine the reason. While stress, pregnancy, or a change in diet can lead to changes in one’s menstrual cycle, it is still vital to be evaluated by a healthcare professional.


Once you’ve spoken with your doctor, some tests will be done. This would rule out this condition along with other health problems. The first tests include a physical exam. Your primary physician will also interview you regarding your menstruation, previous surgeries on the ovaries, and contact with toxins like radiation therapy or chemotherapy.

  1. Pregnancy Test: For women of childbearing age, this is the first test done for missed periods.
  2. Estradiol Test: A type of estrogen coming from the ovaries is called estradiol. This is usually less in number for a woman who has a premature ovarian failure.
  3. Follicle-Stimulating Hormone (FSH) Test: The pituitary gland releases the hormone called FSH. This is what stimulates follicle growth in the ovaries. However, in this condition, women have an alarming level of FSH in their blood.
  4. Karyotype Test: This test involves the examination of the body’s 46 chromosomes to check for an abnormality. As mentioned, you may have chromosomal defects that cause this condition.
  5. Prolactin Test:A hormone in charge of breast milk stimulation and production is prolactin. This hormone may cause problems in a woman’s ability to ovulate.
  6. FMR1 Gene Testing: In fragile X syndrome, the FMR1 gene is linked with this chromosomal defect. With this test, it checks the X chromosomes for abnormalities.

With the help of these tests, your attending physician can clearly detect problems in your ovaries. For women under the age of 40, you will be diagnosed with primary ovarian insufficiency if you manifest the following:

  • High Levels of FSH
  • Low Levels of Estradiol
  • Missed or Irregular Period for a Continued Three Months

A transvaginal ultrasound will also be recommended. This test will give a clear image of your ovaries.


The treatment of primary ovarian insufficiency is typically focused on problems caused by a deficiency in estrogen.

1. Estrogen Therapy

By injecting the body with the needed estrogen, it can relieve symptoms of estrogen deficiency like hot flashes. It can also thwart the risk of osteoporosis. For a woman who still has her uterus, estrogen therapy is combined with progesterone. This helps protect the endometrium, the lining of the uterus.

The combination of estrogen and progesterone may lead to regular menstruation. However, it does not restore the function of the ovaries. Hormone therapy is recommended until the age of 51 but depends on a woman’s preference and health.

Older women should take precautions though as long-term therapy of estrogen and progestin is linked to a heightened risk of breast cancer and cardiovascular disease. On the other hand, for younger women, the risks are outweighed by the benefits of hormone therapy.

2. Vitamin D and Calcium Supplements

Both nutrients are vital to prevent osteoporosis. While it may be absorbed from food or from sun exposure, the amount might not be enough. Before taking calcium supplements, it is important to get a bone density test for a baseline measurement of your bone’s density.

According to the Institute of Medicine, 1,000 milligrams of calcium should be taken by women 19 to 50 years old. For women 51 years and above, the recommended dose is 1,200 milligrams. As for Vitamin D, a prescribed starting dose is 600 to 800 international units (IU) in a day.

If you’ve been suffering from irregular or missed periods, then consult with your doctor immediately. It is important to get checked, especially if you are under 40 years of age and have yet to go through menopause. The tests mentioned can help diagnose if you have premature ovarian failure.

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