Primary Ovarian Insufficiency (POI)

1. Primary Ovarian Insufficiency (POI) | Premature Ovarian Failure (POF) What is Primary Ovarian Insufficiency (POI) ? POI is a problem in which the ovary produces insufficient amounts of ovarian hormones. It is also a cause of infertility that affects approximately 1% of young women under the age of 40. The disorder can be seen in teenagers as young as 13 years of age. It is usually during a visit to her gynecologist that a woman finds out through a measure of her hormone levels that her estrogen is low and her follicle stimulating hormone (FHS) is very high because it's working overtime to get the cycle going. The fact is that, in most cases, her ovarian reserve of eggs is very low. When this insufficiency of eggs occurs in young women, it presents with several symptoms which affects overall physical and emotional health, not just fertility. Primary Ovarian Insufficiency : Some Possible Causes Genetics : Turner's Syndrome FMR1 permutation Other Chromosomal Abnormalities Toxins : Chemotherapy Radiation Viral Infections Surgical Procedure Autoimmune : Autoimmune oophoritis Approximately 90% of women who are diagnosed with Primary Ovarian Insufficiency have no known cause for their disorder which is why more research is needed. Major Symptoms of POI Include Frustration and Hot Flashes A woman with POI tries to understand her diagnosis while managing daily tasks accompanied by symptoms of anxiety, depression, hot flashes, and fatigue.

2. Symptoms and Diagnosis of Primary Ovarian Insufficiency Although the diagnosis of POI may differ for each woman, there are basic symptoms of the disorder. These include: Irregular or missed menstrual cycles Hot flashes during the day and night sweats Mood swings Irritability Inability to focus or concentrate Fatigue and loss of energy Anxiety and/or depression Decreased libido Vaginal dryness and painful intercourse Dry eye or inability to make tears normally Not all women will have every symptom listed. Some women have only a few mild symptoms while others present as severe cases with all symptoms, complicated by a clinical depression and other physical ailments. These basic symptoms resemble a diagnosis of menopause which has often led to the misdiagnosis of a younger woman. This may delay proper care and an opportunity to explore alternatives to having children. This is why it had been very difficult to correctly diagnose POI. Emotional Impact of Primary Ovarian Insufficiency Receiving a diagnosis of infertility is a very painful event in the life of a woman. It's heart breaking for a newly married couple just beginning to start a family and find they aren't conceiving. It is a unique type of grief felt by all parties in the family, including potential grandparents. The uniqueness about Primary Ovarian Insufficiency (POI) is that it strikes women under 40, often in their teens and early twenties. The majority of these women don't have children and most are single at the onset of symptoms. It also creates inner conflicts about identity and purpose as a woman if her identity is strongly based on bearing biological children and becoming a mother. In addition, for single women, they grapple with an added anxiety of having to share the news with a potential mate who may want biological children.

3. The emotional impact of being diagnosed with a rare form of infertility at a young age often requires counseling and support provided by a therapist or support group. A young woman with infertility often feels broken, like an empty flower pot, where blooms were meant to be but never bud. Uncertainty and mixed emotions define the young life of a woman diagnosed with POI, unlike that of menopause in later years, which is an expected event women transition into naturally around the age of 50. Living with Primary Ovarian Insufficiency : Support and Options It is imperative that woman get the help they need early, to address the short-term and long term effects of a Primary Ovarian Insufficiency diagnosis. Early intervention includes treatment, and emotional support will have the greatest impact for success. Consider the following to increase the probability of living optimally with POI: 1.See a gynecologist and/or an endocrinologist for baseline testing as soon as symptoms occur or persist. 2.Don't hesitate to get a second opinion for clarity on diagnosis and proper treatment. It may take several tries before the correct regimen of treatment is found for each unique case. 3.See a therapist or attend an infertility support group to address the emotional impact and devastating loss the diagnosis creates, which may include depression.Talking with other women who understand provides an invaluable connection and bonding to others which makes the burden easier to carry. 4.Empower yourself by researching and learning all you can about the symptoms and treatment of POI. 5.Explore options to having a family which may include donor egg, adoption, surrogacy, spontaneous pregnancy. 6.Take your time to embrace, accept, understand, and heal from the diagnosis before making any major decisions too soon. 7.Engage in other aspects of your life with passion and remembering that fertility is only one part of womanhood and does not have to define your total existence. 8.Take good care of yourself by participating in nurturing activities, e.g., pampering, social and recreational activity, exercise, good nutrition.