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Causes
By Mayo Clinic staff
Your ovaries hold thousands of immature follicles, which contain eggs. At the beginning of each menstrual cycle, your pituitary gland — which secretes a variety of hormones regulating processes throughout your body — secretes follicle-stimulating hormone (FSH). This hormone causes a small number of the egg-containing follicles in the ovaries to begin maturing, although usually only one follicle actually reaches maturity. Maturing follicles make estrogen. In turn, rising estrogen levels "notify" the pituitary gland that FSH is no longer needed.
If the follicles don't mature properly — and don't release adequate amounts of estrogen — the level of follicle-stimulating hormone continues to increase and remains elevated. This is why women with premature ovarian failure often have high levels of FSH circulating in their blood.
In women with normal ovarian function, the pituitary gland releases another hormone, called luteinizing hormone (LH). This hormone causes the mature follicle to open, releasing the egg (ovulation). The egg then enters the fallopian tube where it might be fertilized by sperm — resulting in pregnancy. Without the increased estrogen levels released by maturing follicles and subsequent spike of luteinizing hormone, ovulation doesn't occur.
Premature ovarian failure arises when there are few or no "responsive" follicles left in your ovaries (follicle depletion) or when the follicles aren't responding properly (follicle dysfunction).
What causes follicle depletion
Causes of follicle depletion resulting in premature ovarian failure include:
- Chromosomal defects. Certain genetic disorders are associated with premature ovarian failure. These include Turner's syndrome, a condition in which a woman has only one X chromosome instead of the usual two, and fragile X syndrome, a major cause of mental retardation.
- Toxins. Chemotherapy and radiation therapy treatments are the most common causes of toxin-induced ovarian failure. These therapies may damage the genetic material in cells. Other toxins such as cigarette smoke, chemicals, pesticides and viruses may hasten ovarian failure.
What causes follicle dysfunction
A cause of follicle dysfunction is damage arising from autoimmune diseases. Infrequently, a woman's body may produce antibodies against her own ovarian tissue, which may harm the egg-containing follicles. It's not certain why this occurs, but the process may be initiated by exposure to a virus.
Often, it's difficult to pinpoint an exact cause of premature ovarian failure. In most cases, the cause is unknown.
- Cedars M, et al. Premature ovarian failure. Journal of Clinical Endocrinology and Metabolism. 2008;93:i.
- Do I have premature ovarian failure (POF)? National Institute of Child Health and Human Development. http://www.nichd.nih.gov/publications/pubs/pof/sub1.cfm#what. Accessed Dec. 1, 2008.
- Lobo RA. Menopause: Endocrinology, consequences of estrogen deficiency, effects of hormone replacement therapy, treatment regimens. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/112160892-5/778264621/1524/277.html#4-u1.0-B978-0-323-02951-3..50045-5--cesec1_1347. Accessed Dec. 1, 2008.
- Welt CK. Pathogenesis and causes of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 25, 2008.
- Bulun SE, et al. The physiology and pathology of the female reproductive axis. In: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/112160892-6/778264621/1555/106.html#4-u1.0-B978-1-4160-2911-3..50018-2--cesec91_1490. Accessed Dec. 1, 2008.
- Kalu E, et al. Spontaneous premature ovarian failure: Management challenges. Gynecological Endocrinology. 2008;24:273.
- Nelson LM, et al. Evaluation of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 25, 2008.
- Nelson LM, et al. Management of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 25, 2008.
