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Treatments and drugs

By Mayo Clinic staff

Treatment for premature ovarian failure is usually tailored to address the problems that arise from estrogen deficiency:

  • Estrogen therapy. Replacing the estrogen that's normally produced by functioning ovaries is important to help prevent osteoporosis and relieve symptoms of estrogen deficiency, such as vaginal dryness and hot flashes. If estrogen is prescribed, usually you'll also be advised to use another hormone, progesterone, to protect the lining of your uterus (endometrium) from precancerous changes that can result if you take estrogen alone. Use of estrogen and progesterone may cause you to have menstrual periods again. Hormone replacement therapy may be taken as a pill, applied to your skin as a gel or a patch, or administered as a vaginal ring. You'll likely continue taking hormonal therapy until about the age of 50 or 51 — the average age of natural menopause.

    Some women express concern about taking hormone replacement therapy because of reported associations between long-term estrogen therapy and cardiovascular disease and breast cancer incidence in older women. However, in young women with premature ovarian failure, the benefits of hormone replacement therapy usually outweigh the potential risks.

  • Calcium and vitamin D supplements. Taken together, these supplements are important for bone health and help reduce the development of osteoporosis. Your doctor will probably advise you to have bone density testing done before starting supplements so that you'll have some idea of your baseline bone density measurement.

Addressing infertility
Infertility is a common complication of premature ovarian failure. There's no treatment proved to restore fertility in women with this condition. However, some women and their partners choose to pursue a pregnancy through in vitro fertilization using donor eggs. The procedure involves removing eggs from a donor and fertilizing them with your partner's sperm in a laboratory. The fertilized egg (embryo) is then placed in your uterus. During this process, you take medication that balances your hormones to support a pregnancy. Once the pregnancy is established, you stop taking the medication and the pregnancy proceeds naturally to the delivery.

References
  1. Cedars M, et al. Premature ovarian failure. Journal of Clinical Endocrinology and Metabolism. 2008;93:i.
  2. 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.
  3. 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.
  4. Welt CK. Pathogenesis and causes of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 25, 2008.
  5. 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.
  6. Kalu E, et al. Spontaneous premature ovarian failure: Management challenges. Gynecological Endocrinology. 2008;24:273.
  7. Nelson LM, et al. Evaluation of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 25, 2008.
  8. Nelson LM, et al. Management of spontaneous premature ovarian failure. http://www.uptodate.com/home/index.html. Accessed Nov. 25, 2008.

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Dec. 31, 2008

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