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Midlife and Menopause

Premature Ovarian Failure

If you are under forty years old, your ovaries have stopped working as they usually do, and you have not had gynecological surgery, chemotherapy, or radiation treatment, you may be diagnosed with premature ovarian failure (POF). Some health care providers also use the term ovarian insufficiency to describe this condition. POF may occur years or decades before the typical age for menopause. Sometimes your menstrual periods may completely stop, but often with POF you may still menstruate sporadically. In fact, sometimes POF is not classified as strictly early menopause, because the biological causes can be different.
Researchers have not been able to determine exactly why some women’s ovaries stop working as usual at an early age. While autoimmune disorders, chromosomal disorders, smoking, and certain viruses have been implicated, some of us may just be genetically programmed to go through menopause at a younger age than others. In this case, despite the medical terminology, your ovaries have not really “failed,” they have simply completed their mission earlier than usual. Just as women begin menstruation at different ages, women also reach menopause at different ages. Also, sometimes ovarian function may be temporarily disrupted and may resume again.

Early natural menopause appears to be least common among Japanese-American women (0.1 percent of whom experience early natural menopause, according to a recent study) and most common among African-American women and Latinas (with 1.4 percent of women in these groups experiencing early natural menopause).16 About 1 percent of white American women and 0.5 percent of Chinese-American women experience early natural menopause. Early natural menopause is also more common among women who are poor.17

It is not usually possible to know whether your POF is temporary. In addition, the specific cause of your POF may never be found. A thirty-six-year-old woman with premature ovarian failure describes her frustration with this uncertainty:

When I finally got the POF diagnosis, after years of these weird and awful symptoms, I was in shock. I could not believe I was sitting there and my doctor was telling me,“Yes, it’s POF but we really can’t tell you how you got it.” I was like, “What? You’re the doctor. Tell me how I got this awful thing!” I truly think that’s one of the worst parts of the diagnosis—not knowing.

Some women may blame ourselves for behaviors or risks that we think may have brought on our POF. We often try to find a “reason” when there doesn’t appear to be a definite cause. Most causes of early menopause are beyond our control. Some factors that may affect POF are discussed in the following pages.

End of excerpt
Excerpted from Chapter 4: Sudden and Early Menopause in Our Bodies, Ourselves: Menopause  © 2006 Boston Women's Health Book Collective


16. J. L. Luborsky, P. Meyer, M. F. Sowers, E. B. Gold, and N. Santoro, "Premature Menopause in a Multi-Ethnic Population Study of the Menopausal Transistion," Human Reproduction 18, no.1 (2002):201. [back to text]

 17. Ibid., 204.  [back to text]

Excerpted from Our Bodies, Ourselves: Menopause, © 2006, Boston Women's Health Book Collective.

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