Primary Ovarian Insufficiency (POI)
Primary Ovarian Insufficiency (POI) is a condition in which the ovaries stop functioning in women before the age of 40.In this condition the ovary doesn’t release an egg each month as it usually does.This disorder also known as premature ovarian failure or premature menopause, but these terms are rather confusing as a woman with primary ovarian insufficiency do not always stop menstruating and still have some function with her ovaries.It can be sometime referred as Diminished Ovarian Reserve (DOR), if there is low egg supply involved with the infertility. It should be noted that low egg supply occurring prematurely may have significant implications beyond fertility. Also, this disorder does not always mean that a woman is aging prematurely; it means only that her ovaries are no more functioning normally.In primary ovarian insufficiency:
- The ovaries release eggs intermittently or completely stop releasing it.
- Stop producing the hormones testosterone, estrogen and progesterone or produce only intermittently.
This disorder isn’t rare. But it generally occurred to women younger than age 40. It’s more commonly found in women in their 30s than those in their 20s and teens. It can have impact on both women who have had children and those who haven’t.
Causes of Primary Ovarian Insufficiency
The exact cause of POI is unknown.Researchers are still working to know the root causes of POI.It can be result from any health problem that reduces the number of eggs in the ovaries or problems with the follicles. Follicles are small sacs in the ovaries. Human eggs grow and mature inside it. There may two different types of problem associated with the follicle, the first is that there is insufficient availability of working follicles earlier than normal and secondly the follicles are may not working properly. Some of the known causes of POI can be as under:
- Genetic and chromosomal disorders: Disorders such as Fragile X syndrome and Turner syndrome can results in follicle depletion.
- Chemotherapy or radiation therapy: The treatments for cancer may damage the genetic material in cells including follicle cells.
- Toxins substances: Interaction with chemicals or pesticides, smoking cigarette can speed up follicle depletion. Apart from these causes, viruses have been shown to affect follicle function.
- Metabolic disorders. These disorders may cut down the body’s ability to create store and utilize the required energy needed by the body. For example, galactosemia affects how a woman body processes galactose, a form of sugar and it is found that more than 80% of women and girls with galactosemia also have POI.
- Hormonal problems: Problems with hormones that regulate the ovaries such as follicle-stimulating hormone (FSH).
- Autoimmune diseases: Normally, the body’s immune cells protect the body from outside invading viruses and bacteria. But with POI, the immune system may start destroying developed follicles in the ovaries. It could also damage the glands that make the hormones necessary for the ovaries and follicles to function properly. Some studies suggest that about 20% of women suffering with POI have an autoimmune disease.