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Treatments and drugs
By Mayo Clinic staffTreatment for premature ovarian failure is usually tailored to address the problems that arise from estrogen deficiency:
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Estrogen therapy. To help prevent osteoporosis and relieve hot flashes and other symptoms of estrogen deficiency, it's important to replace the estrogen your ovaries have stopped producing. Estrogen is typically prescribed with another hormone, progesterone. Adding progesterone protects the lining of your uterus (endometrium) from precancerous changes caused by taking estrogen alone. The combination of hormones may cause you to have vaginal bleeding again, but it won't restore ovarian function. You can take estrogen as a pill, a gel or patch applied to your skin, or a vaginal ring, which you replace every three months. You'll likely continue taking hormonal therapy until about the age of 50 or 51 — the average age of natural menopause.
In older women, long-term estrogen therapy has been linked to an increased risk of cardiovascular disease and breast cancer. In young women with premature ovarian failure, however, the benefits of hormone replacement therapy usually outweigh the potential risks.
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Calcium and vitamin D supplements. Taken together, these supplements are important for preventing osteoporosis. Your doctor may advise you to have bone density testing done before starting supplements so that you'll have some idea of your baseline bone density measurement.
The Institute of Medicine recommends 600 international units (IU) of vitamin D a day for adults ages 19 to 70. For adults age 71 and older, the recommendation increases to 800 IU a day. For women ages 19 to 50, the calcium recommendation is 1,000 milligrams (mg) a day, increasing to 1,200 mg a day for women age 51 and older.
Addressing infertility
Infertility is a common complication of premature ovarian failure. There's no treatment proved to restore fertility in women with this condition. It's important to understand and grieve for this loss of ovarian function and to seek counseling if you need it.
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.
- 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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