What is Premature Ovarian Insufficiency (POI)?

If your periods have stopped or have become very irregular for 3 months in a row, in order to work out the cause, your doctor will do blood tests to check your hormone levels, and a pelvic ultrasound to check your ovaries.

Besides those menstrual changes, if you are also experiencing the following symptoms, you might possibly be diagnosed with Premature Ovarian Insufficiency:

• Menopausal symptoms such as hot flushes, night sweats
• Anxiety, depression or mood swings
• Concentration or memory problems
• Low libido (decreased sexual desire)
• Vaginal dryness causing painful intercourse

How is Premature Ovarian Insufficiency diagnosed?

You will be diagnosed with ‘premature ovarian insufficiency’ if you are under 40 years of age, have had two lots of blood tests at least 1 month apart showing very high FSH (follicle stimulating hormone) levels and very low oestradiol (oestrogen) levels. This means that your ovaries aren’t able to make enough oestrogen to produce follicles.

These follicles are small sacs that lie inside your ovaries. They support your eggs as they grow and mature. In POI, your follicles may either run out (depletion) or they might not work efficiently (dysfunction).

What other names are given to this condition?

Besides being called Premature Ovarian Insufficiency, this condition is also often referred to as ‘Premature Ovarian Depletion’ (POD); ‘Premature Ovarian Failure’ (POF) and ‘Premature or Early Menopause’.

What causes Premature Ovarian Insufficiency?

It is not always possible to identify the cause of this condition. In about 60% of women, a cause cannot be found. However, some identifiable causes may include:

• Family History – if your mother or sister has POI, there is a 10% chance you might inherit it.
• Surgery – removal of the ovaries results in instant menopause
• Cancer treatments – chemotherapy and radiotherapy cause ovaries to weaken
• Genetic disorders – such as Turner syndrome and Fragile X premutation carriers.
• Autoimmune diseases – including Thyroiditis and Addison disease
• Metabolic disorders
• Toxins – such as cigarette smoke and pesticides

Can Premature Ovarian Insufficiency affect my chances of getting pregnant?

With many women experiencing POI, difficulty getting pregnant is the reason they go to their doctor initially. Because POI causes lower levels of certain hormones, they are also at a greater risk for other health conditions besides infertility, such as heart disease, hypothyroidism, osteoporosis, anxiety and depression.

How is Premature Ovarian Insufficiency treated?

If you have been struggling with your fertility for a while, this kind of diagnosis would come as such a shock to you and your partner. Couples who come to me with this condition are distressed and worried that they may not be able to get pregnant.

Naturopathy can address many of the symptoms associated with POI.

As a fertility naturopath, I always assess my patients with POI and tailor a programme that’s specific to their individual needs.

Lifestyle modifications are essential.

• A healthy diet is one of the most important lifestyle modifications that need addressing. I discuss this at length with my patients and help them work out a wholesome nutritional regime that suits them best.
• If necessary, I advise them to stop smoking. There is so much research and evidence validating the fact that smoking and other chemical toxins such as pesticides act as endocrine (hormone) disruptors.
• I also encourage them to adhere to the recommended alcohol intake – and if possible, encourage them to stop drinking alcohol all together.
• Regular weight-bearing and aerobic exercise is essential.
• And so is fresh air, sunshine and meditation / relaxation.

There are some proven herbs and supplements that are known to help:

• Balance your hormones
• Assist with detoxification
• Relieve stress
• Improve mood
• Enhance energy
• Boost libido (sexual desire)

If you have been recently diagnosed with Premature Ovarian Deficiency, or are struggling with symptoms of early menopause, it would be my pleasure to support you with whatever your needs may be.

Joanne Lipinski – Fertility Naturopath Melbourne