Kate Davies, Fertility Nurse Consultant, IVF coach and founder of Your Fertility Journey explains Premature Ovarian Insufficiency and how it can affect fertility.
Premature Ovarian Insufficiency
Premature Ovarian Insufficiency (POI) is sometimes referred to as premature or early menopause, and is the term used to describe when the ovaries stop working before the age of the natural menopause. On average a women’s menopause occurs around the age of 55. Sadly, POI occurs in 1in 100 women under the age of 40, 1 in 1000 women under the age of 30 and 1 in 10,000 women under the age of 20. Some women diagnosed with POI can still be in their teenage years.
What are the symptoms of premature ovarian insufficiency?
In women who are very young, their periods may not start at all and this can be an indication, among other reasons, of the condition. Women, who have previously had periods, may notice that their periods become irregular and then stop altogether. Other symptoms you may notice are:
- Hot flushes and night sweats
- Insomnia/disrupted sleep
- Weight gain (especially around waist and abdomen)
- Skin and hair changes (dryness, thinning)
- Breast tenderness
- Mood swings and irritability
- Anxiety/panic attacks
- Loss of self-esteem
- Lowered libido
- Difficulty concentrating and memory lapses
- Fatigue/low energy levels
- Joint/muscle pain
- Vaginal dryness and urinary infections
How is premature ovarian insufficiency diagnosed?
Unfortunately it can be difficult to diagnose POI, and initially you may be diagnosed with other conditions that may cause periods to cease, such as polycystic ovary syndrome (PCOS). A definitive diagnosis is obtained by taking a blood sample of follicle Stimulating Hormone (FSH) and repeating 4 weeks later. FSH levels above 30 iu/l are an indicator that the ovaries are failing and menopause is approaching or has happened. However, levels can fluctuate significantly in the early stages of POI, contributing to the difficulty in diagnosing the condition.
What is the treatment for POI?
Treatments for POI include hormone replacement therapy (HRT) or the combined oral contraceptive pill. Treatment is important to reduce the risks of long-term conditions such as osteoporosis. Oestrogen levels significantly reduce when the ovaries stop working and healthy bones require good amounts of oestrogen. HRT treatment improves bone density and therefore reduces the likelihood of osteoporosis occurring.
What does premature ovarian insufficiency mean for my fertility?
Women diagnosed with POI are more likely to conceive using donor egg and IVF. This can initially be devastating news and it’s important to take time to consider your options and what feels right for you and your partner. Speaking with your doctor and couples who have experience of conceiving using egg donation, can be helpful in getting all the information you need.
Where can I get more information and support?
The Daisy Network is a charity dedicated to supporting women with POI. They provide a support network of people to talk to, and offer advice on the treatments available, as well as keeping you up to date with research within the fields of HRT and assisted conception
You can also become a member of the Daisy Network and receive the following benefits:
- cheaper annual conference tickets
- Treatment options going forwards
- Access to The Daisy Network Forum and their closed Facebook group to connect with other members
- Access to videos and live chat sessions where you can ask questions to their medical experts Downloadable factsheets covering health, fertility and psychological topics and much more.
Kate Davies (RN, BSc (Hons), FP Cert) is a fertility nurse consultant and IVF coach. She is the founder of ‘Your Fertility Journey’, a clinic offering high quality advice and support for women and couples who were struggling to conceive. Find out more about Your Fertility Journey here. Kate is also co-host of The Fertility Podcast.