PREMATURE OVARIAN INSUFFICIENCY (Part 2)

Last week we talked about possible causes, signs and symptoms of POI, this week we will be talking about complications and management.

Complications that may be associated with POI includes

• Infertility:Inability to get pregnant may be the most troubling complication of premature ovarian failure, although in rare intermittent cases, pregnancy is possible until the eggs are depleted.
• Osteoporosis:The hormone estrogen helps maintain strong bones. Women with low levels of estrogen have an increased risk of developing weak and brittle bones (osteoporosis), which are more likely to fracture and takes longer to heal than healthy bones.
• Depression or Anxiety.The risk of infertility and other complications arising from low estrogen levels causes some women to become depressed or anxious.
• Heart disease.Early loss of estrogen might increase the risk for a heart disease.
• Dementia.Lack of estrogen can contribute to this in some people.
• Hypothyroidismand other autoimmune disorders

HOW DO I KNOW IF I HAVE PREMATURE OVARIAN INSUFFICIENCY?It is really traumatizing to be informed by your physician that you may not be able to fulfill your dreams of starting or enlarging your family. This can be quite confusing to a young career minded female.  Highrates of suicide in cases of POI have been documented,therefore, individual or group counseling support systems must be available to them.

Most women have few signs of premature ovarian failure. Diagnosis usually involves a physical and pelvic exam. Your doctor might ask questions about your menstrual cycle, exposure to toxins, such as chemotherapy or radiation therapy, and previous ovarian surgery.

Your doctor might recommend one or more of these tests:

• Pregnancy test.These checks for an unexpected pregnancy in a woman of childbearing age who has missed a period.
• Follicle-stimulating hormone (FSH) test.This is thehormone released by the pituitary gland that stimulates the growth of follicles in your ovaries. Women with premature ovarian failure often have abnormally high levels of FSH in their blood.
• Estradiol test.The blood level of estradiol, a type of estrogen that comes from the ovaries, is usually low in women with premature ovarian failure.
• Prolactin test.High blood levels of this hormone that stimulates breast milk production can lead to inhibition of ovulation, and in some cases irregular or absent menstrual periods.
• Karyotype.This test examines your 46 chromosomes for abnormalities. You could have only one X chromosome instead of two XX that is the normal in females or other chromosomal defects.
• FMR1 gene testing.The FMR1 gene is the gene associated with fragile X syndrome — an inherited disorder that can cause intellectual problems. The FMR1 test looks at both of your X chromosomes to make sure they appear normal

IS POI TREATABLE?

Studies have shown that 5-10 % of women affected by Premature Ovarian Insufficiency get pregnant naturally.

Ongoing clinical research, using a mild hormone DHEA (Dihydroepiandrosterone) is showing very promising results with pregnancies in women especially those withintermittent POI.  Groups both in the USA and Greece have had good successes achieved using this hormone for IVF, IUI and natural conceptions.

Use of a transdermal Estrogen patch as prescribed and monitored by a certified Fertility Specialist has also yielded some good results.

Adding Calcium and Vitamin D supplement to your diet, to prevent osteoporosis, as determined by results of your bone density testing is required

Eat healthy. Enjoy plenty of green vegetables and fruits in your diet. Do weight bearing exercises such as walking.

Pay close attention to your physical and emotional health. Many become confused, extremely stressed and anxious on learning about the shutdown of their body’s fertility window. Failure to conceive can create grave psychological dysfunction to a family relationship, especially in this part of the world, where the birth of a child or heir is a requirement to maintaining the relationship.  Emotional stress, anxiety even depression is common in many cases of Premature Ovarian Insufficiency.

Keep a diary of your periods. Take particular attention to the hormone therapy given, follow the instructions carefully. Report any missed doses.

Coping with POI: Why me?

You may find yourself asking this question what you could I possibly have done to deserve this. Dealing with the emotional realities of premature menopause can be difficult, but this isn’t your fault. You deserve compassion and understanding, from others and from yourself.

Seek counseling and learn more on how to cope and enjoy a beautiful life with great possibility of fulfilling your dream of expanding your family.

When you learn you have POI, you suddenly feel older, different from your peers. You feel you have been cheated out of the normal possibilities of life. In your 20s or 30s, you are unable to fulfill the “normal” reproductive capacity women have.

You become plunged into a completely different mind-set than the one you had before you were diagnosed. Your body is out of control and you are helpless to change what is happening. You’re angry, upset, and numb. But, somehow, you have to keep going…stop moaning, move on.

Acceptance, coping and moving forward is the way out. The faster you recover from the depressive state the better for you. You can live with Premature Ovarian Insufficiency and still be beautiful, sexy, have desired number of children and live a fulfilled life.