Primary ovarian insufficiency

Primary ovarian insufficiency, also called premature ovarian insufficiency or premature ovarian failure, is the partial or total loss of the ovaries' reproductive and hormonal function before age 40, caused by follicular dysfunction or early loss of eggs. It sits on a spectrum of change leading to menopause but with earlier onset and variable severity, and ovarian function occasionally returns. It affects about 1 in 10,000 women under 20, 1 in 1,000 under 30, and 1 in 100 under 40. Symptoms resemble menopause: hot flashes, night sweats, vaginal dryness, irregular periods, anxiety, depression and reduced libido, and diagnosis is often described by patients as devastating and confusing. In 39 to 67 percent of cases the cause is idiopathic; other causes include genetic disorders, autoimmune disease, enzyme deficiency, infection, environmental toxins, radiation and surgery. The condition was first described in 1942 by Fuller Albright and colleagues. Treatment centers on hormone replacement therapy with estrogen and progesterone, assisted reproductive technology for fertility, and psychosocial support.