Ovarian exhaustion syndrome

What is it about?

A woman's menopause usually occurs after the age of 45 and is accompanied by a gradual decline in fertility due to a decrease in the ovarian reserve of the ovaries. However, there is a condition called "premature menopause" or premature ovarian insufficiency syndrome. It is characterized by a loss of fertility in women under the age of 40. About 1% of women in this age group are affected by this diagnosis. Patients often notice a prolonged absence of menstruation and pronounced hormonal deficiencies.

Causes of premature ovarian insufficiency syndrome

Among the most common causes of early menopause are the following:

• An insufficient number of follicles deposited in the ovaries at birth.
• Chromosomal abnormalities (for example, Turner syndrome, Turner mosaic syndrome, X chromosome deletion syndrome).
• Damage to ovarian tissue due to surgery, chemotherapy, or radiation therapy.
• Genetic mutations, such as mutations in the FMR1 gene.
• Autoimmune disorders, including dysfunction of the thyroid, parathyroid, and adrenal glands.

Symptoms of ovarian insufficiency syndrome

Some women suffering from a primary or latent form of ovarian insufficiency may exhibit no obvious symptoms. In this case, the only impact is the inability to conceive. In other situations, the following signs may manifest:

• Infrequent and scant menstruation.
• Hot flashes accompanied by night sweats.
• Vaginal dryness.
• Decreased libido.
• Mood swings, including depression.
• Atrophic vaginitis and osteoporosis caused by estrogen deficiency.

Diagnosis of ovarian insufficiency syndrome

Doctors prescribe the following tests for diagnosis:

• Analysis of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels.
• Ovarian ultrasound to assess the number of antral follicles.
• Genetic tests to detect chromosomal abnormalities.
• Additional tests to evaluate thyroid hormones, glucose levels, blood electrolytes, and creatinine.

Treatment of premature ovarian insufficiency syndrome

The main treatment method is estrogen-progestin replacement therapy, which helps restore hormonal balance and reduce symptoms such as hot flashes and vaginal dryness. However, it is important to be aware of potential side effects, including the risk of thrombosis, liver dysfunction, and increased migraines. These aspects require regular follow-up with a physician. In 5 to 10% of cases, this therapy allows for the artificial restoration of cycles.

For women considering pregnancy, the most effective option remains the in vitro fertilization (IVF) program using donor eggs.

What should I do if pregnancy is not possible?

If you have difficulty conceiving, it is important to consult a reproductive doctor in a timely manner. During a consultation, you can discuss possible causes of infertility, undergo tests, including hormone tests and ultrasounds, and consider treatment options. The specialist will help you determine if the difficulties are related to premature ovarian insufficiency syndrome and will develop an optimal examination and treatment plan. An appointment with a specialist significantly increases the chances of successful treatment and achieving reproductive goals.