no period, yet not pregnant? here is a possible reasonOctober 24, 2018 6.26 AM
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The first sign of primary ovarian insufficiency is usually irregular or missed periods. Later symptoms may include decreased sex drive, pain during sex and vaginal dryness. Photo credit: verywellfamily.com
Primary ovarian insufficiency (POI), also known as premature ovarian failure, happens when a woman's ovaries stop working normally before she is 40. This means they may have irregular periods and reduced fertility before the age of 40. Sometimes it can start as early as the teenage years. In most patients, causes are usually unknown.
University of Malaya, Faculty of Medicine, Department of Medicine senior lecturer and consultant Endocrinologist Dr Lee Ling Lim explained that other possible causes include chromosomal abnormalities such as Fragile X Syndrome, co-occurrence with certain hormonal disorders such as low parathyroid/adrenal/thyroid hormones (usually antibodies-related), autoimmune: presence of ovarian antibodies or the damage to the ovaries after chemotherapy or radiation therapy. “Adolescents or young women are usually affected by POI. The most common symptoms is the presence of irregular menses for at least three months, after excluding the use of birth control pills and other hormonal disorders that can affect the menstrual cycle such as high prolactin level and low thyroid hormones. The presence of family history of premature menopause could also be a possible cause.” Basic blood tests include FSH and oestrogen levels – two random tests which are a month apart, prolactin level and thyroid hormones test. Treatment Affected individuals tend to be co-managed by the endocrinologists, fertility specialists and paediatricians specialised in growth and development. Hormonal therapy is used to replace the oestrogens (female hormone) until the natural age of menopause for optimal bone health, pubertal growth and sexual maturation, as well as prevention of cardiovascular disease. For the latter, additional strategies include dietary control, regular exercise and smoking cessation. Individuals need to be referred to fertility specialists for advice on the reproductive techniques. |
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