A woman’s ovaries produce a hormone called estrogen and release one egg each month. Women are born with a limited number of eggs in their ovaries and do not produce new ones after birth. On the contrary, from the very moment of birth, a woman begins to lose eggs, and eventually, they become depleted. This usually occurs around the age of 50, a stage known as menopause, which is an irreversible and permanent process.

When a woman’s ovaries stop functioning before the age of 40, she is considered to have premature ovarian insufficiency (POI), which affects approximately 1% of women. Unlike menopause, ovarian insufficiency can appear and disappear—it can be intermittent.

Women with POI do not release eggs or produce estrogen; therefore, their symptoms may vary and include menstrual irregularities, absence of menstruation, infertility, or menopause-like symptoms such as hot flashes, vaginal dryness, night sweats, or difficulty sleeping. Some women may have no symptoms at all and only discover they have POI when undergoing fertility tests.

In most cases, the cause of ovarian insufficiency is unknown; however, sometimes chromosomal abnormalities such as Turner syndrome or Fragile X syndrome can be identified, as well as a history of treatments that may affect ovarian function, such as chemotherapy or radiotherapy, or autoimmune diseases as potential causes of POI.

Because estrogen is an essential hormone throughout a woman’s life, a premature decrease or absence of this hormone can increase the risk of developing osteoporosis, hypertension, heart attacks, and depression. In addition, since the ovaries do not produce eggs, women with ovarian insufficiency suffer from infertility.

To determine whether a woman has POI, it is necessary to evaluate her menstrual cycle and perform blood tests to analyze hormones such as estrogen and follicle-stimulating hormone (FSH). If these levels are abnormal, a second test is required to confirm the diagnosis. To identify the cause of the condition, additional tests may be needed, depending on the findings from the physical examination or medical interview.

Does ovarian insufficiency have a treatment?

It is a condition that does not have a specific treatment, but the symptoms can be managed by replacing the hormones—such as estrogen and progesterone—that the ovaries have stopped producing. Some women may experience periods in which their ovarian function returns, allowing them to temporarily discontinue hormone replacement therapy.

Can a woman with POI become pregnant?

Most women with ovarian insufficiency are unable to become pregnant naturally. In Vitro Fertilization using donated eggs is an alternative with high pregnancy success rates.