Reproductive Q&A for Cancer Survivors:
Premature Ovarian Failure (POF)
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What is premature ovarian failure (POF)?
If your ovaries are no longer able to release either hormones or eggs, you are experiencing premature ovarian failure (POF). Premature means, "before it is supposed to happen." If you are experiencing POF, your ovaries have stopped making the hormone estrogen and you will not get your period.
What are the symptoms of premature ovarian failure (POF)?
POF symptoms may include:
The two most common symptoms that adolescents with POF report are lack of breast development and/or a lack of menstrual periods.
If you think you have POF, talk to your health care provider since other medical conditions may cause the same or similar symptoms. |
How is POF diagnosed?
Your doctor can find out if your ovaries are working by doing a simple blood test to check two hormone levels, FSH and estrogen. Sometimes it's necessary to repeat the blood test to figure out the average number or level. High levels of FSH and low levels of estrogen in a blood test usually mean that you have ovarian failure.
Why are the hormones FSH and Estrogen so important?
In menstruating women, the pituitary gland in the brain can sense if the ovaries are making the right amounts of estrogen. If a woman is not getting her period and there is no estrogen being made, the pituitary gland in the brain will release a hormone called the follicle-stimulating hormone (FSH). This hormone sends a signal to the ovaries telling them to start making estrogen.
Your ovaries should respond to this signal and begin to release estrogen. When the estrogen is released, the pituitary gland then stops sending out FSH and the level of FSH in your blood stream lowers. However, if you have POF, your ovaries can't make estrogen so the amount of FSH in your blood stays very high.
Is POF permanent?
POF can be unpredictable. After treatment for cancer, you may or may not get back regular menstrual cycles and ovarian function. It is possible to have POF after cancer treatment but later have your ovaries return to making hormones and possibly eggs. Unfortunately, there is not an available test at this time for health care providers to tell for sure if POF will be permanent.
How is POF treated?
The treatment for POF is to replace the hormones your body is no longer making. The name for this type of treatment is called hormone replacement therapy, or HRT. The hormones that need to be replaced are estrogen, progesterone or both. These hormones are necessary for breast development, menstrual periods, and healthy bones.
There are different types of HRT. HRT is available as pills, skin patches, and shots. Pills are usually the easiest type of HRT for young women to take, although some women prefer using patches that are applied to the skin once or twice a week. Birth control pills are often used as an HRT because they contain estrogen and progesterone.
Although HRT may help to replace the hormones that your ovaries don't make anymore, there is no way to replace your eggs if they have been damaged by cancer treatment.
What are the effects of Hormone Replacement Therapy (HRT)?
Your breasts may increase in size if they have not finished growing. You may start having menstrual periods if your uterus is healthy. You may get PMS, menstrual cramps, irregular menstrual periods, or mood swings, just like you would if your body was making the progesterone and/or estrogen.
If you are having any side effects from the HRT, it is important to discuss them with your health care provider. There are more than 25 different types of HRT, and your provider can work with you to find the one that is best for you.
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Updated: 3/12/2006
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