Premature Ovarian Failure (POF)

Premature ovarian failure (POF), also known as primary ovarian insufficiency, is the loss of normal ovarian function before the age of 40.

Clinical Features

1. Amenorrhea: Absence of menstrual periods for at least 4 months.
2. Vasomotor Symptoms: Hot flushes and night sweats.
3. Other Symptoms: Vaginal dryness, irritability, and decreased libido.

Diagnosis

i. FSH Measurement: Elevated follicle-stimulating hormone (FSH) levels measured on two separate occasions, at least four weeks apart, confirm the diagnosis.
ii. Additional Tests: Oestradiol levels, karyotype analysis, and autoimmune screening may be considered.

Risk Factors

i. Genetic Disorders: Turner syndrome, Fragile X syndrome.
ii. Autoimmune Diseases: Addison’s disease, thyroiditis.
iii. Medical Treatments: Chemotherapy, radiation therapy.
iv. Infections and Toxins: Mumps oophoritis, smoking.

Management

.  Hormone Replacement Therapy (HRT): Recommended until the average age of menopause (51 years) to manage symptoms and prevent long-term consequences such as osteoporosis.
. Calcium and Vitamin D: Supplementation to support bone health.
. Lifestyle Modifications: Diet, exercise, and smoking cessation.