Have you heard of primary ovarian insufficiency? I haven’t, but I am sure the women who have this condition are very interested in it since it can cause many of the symptoms of menopause – such as hot flashes – as well as threaten bone health.
It turns out that primary ovarian insufficiency -- which also is known as premature ovarian failure --affects one in 100 women by the time they reach the age of 40. This spontaneous condition happens when ovaries stop producing sufficient estrogen without any reason (such as anorexia chromosome abnormality or chemotherapy). These women often have irregular menstrual cycles or miss their period altogether. In addition, they may experience hot flashes. Symptoms of premature ovarian failure also include night sweats, vaginal dryness, irritability, difficulty concentrating and decreased sexual desire.
These women also often experience issues with their fertility since they have abnormally low levels of reproductive hormones. The hormones affected include estradiol, which is a form of estrogen that is created in the ovaries, and testosterone, which is produced by women in small amounts.
All of those bodily changes make it sound like these women are going through premature menopause. However, the Mayo Clinic states that this is not the case. Women who have premature ovarian failure can have irregular periods for years and may become pregnant; in comparison, women who enter premature menopause do not have periods and are unable to conceive a child.
Treatment often focuses on issues that develop due to estrogen deficiency. Therefore, women who have this type of insufficiency may take estrogen therapy and calcium and vitamin D supplements. However, there is no treatment to restore fertility.
Another issue that can arise is bone loss since women with this condition tend to have diminished bone mineral density, which can result in osteoporosis and bone fractures. This is a similar issue that can arise among women once they go through menopause. Therefore, researchers are exploring whether treatments that are used with menopausal women might also work with these younger women.
A new study out the Eunice Kennedy Shriver National Institute of Child Health and Human Development involved 145 women who had primary ovarian insufficiency and 70 women with normal ovarian function. The women with primary ovarian insufficiency were randomly assigned to one of two groups. One group received a 100 mcg estradiol patch, progestin pills and a placebo patch. The other group received a 100 mcg estradiol patch, progestin pills and a 150 mcg testosterone patch. The women with normal ovarian function did not receive any treatments but did have their bone mineral density measured.
When the study began, researchers found that women who had premature ovarian insufficiency had significantly lower bone mineral density levels in their lower hip and spine when compared to the group of women with normal ovarian function. By the end of the study, the researchers found that both groups that received treatments had significant increases in the bone mineral density. In fact, both groups had bone density measures that matched the women who did not have primary ovarian insufficiency. However, the researchers found that the addition of the testosterone patch did not prove to be statistically significant in helping increase bone mineral density.
“While hormone replacement therapy’s effect on bone mineral density has been studied in postmenopausal women, there is limited research on the effects of this therapy in younger women,” said lead author Dr. Vaishali B. Popat, an endocrinologist who helped conduct this study. “This study provides important evidence that hormone replacement therapy with an appropriate dose of estradiol delivered via a skin patch combined with oral progestin can improve bone density to normal in women with primary ovarian insufficiency.”
Primary Sources for This Sharepost:
Mayo Clinic. (2014). Premature ovarian failure.
National Institutes of Health. (2014). Hormone treatment restores bone density for young women with menopause-like condition.
Published On: June 16, 2014