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Causes
By Mayo Clinic staff
In women with normal ovarian function, the pituitary gland releases certain hormones during the menstrual cycle, which causes a small number of egg-containing follicles in the ovaries to begin maturing. Usually, only one follicle reaches maturity each month. When the follicle is mature, it bursts open, releasing the egg. The egg then enters the fallopian tube, where a sperm cell might fertilize it, resulting in pregnancy.
Premature ovarian failure results from one of two processes — follicle depletion or follicle disruption.
Follicle depletion
Causes of follicle depletion 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.
Follicle dysfunction
Follicle dysfunction may be the result of:
- An immune-system response to ovarian tissue (autoimmune disease). Your immune system may produce antibodies against your own ovarian tissue, harming the egg-containing follicles and damaging the egg. What triggers the immune response is unclear, but exposure to a virus is one possibility.
- Unknown factors. If you develop premature ovarian failure through follicular dysfunction and your tests indicate that you don't have an autoimmune disease, further diagnostic studies may be unnecessary. An exact underlying cause often remains unknown.
- Rebar RW. Premature ovarian failure. Obstetrics & Gynecology. 2009;113:1355.
- Do I have premature ovarian failure (POF)? National Institute of Child Health and Human Development. http://www.nichd.nih.gov/publications/pubs/pof/index.cfm. Accessed Nov. 16, 2010.
- 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/208746819-4/0/1524/0.html. Accessed Nov. 16, 2010.
- Welt CK. Pathogenesis and causes of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 15, 2010.
- Bulun SE, et al. The physiology and pathology of the female reproductive axis. In: Kronenberg HM, et al. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/191205553-3/0/1555/0.html#. Accessed Nov. 16, 2010.
- 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. 15, 2010.
- Nelson LM, et al. Management of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 15, 2010.
- Coddington CC (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 29, 2010.
- Dietary Reference Intakes for calcium and vitamin D. Institute of Medicine. http://www.iom.edu/vitamind. Accessed Dec. 10, 2010.
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