What is POI?
If your doctor has told you that you have POI, your
ovaries are no longer able to release hormones or eggs and you will not
get your period. This condition is called premature ovarian
insufficiency. Premature means, "before it is supposed to happen." Ovarian insufficiency means that the ovaries are not working as they should be.
What are the symptoms of premature ovarian insufficiency (POI)?
POI symptoms may include:
- Lack of development during puberty
- Amenorrhea (no menstrual periods)
- Decrease in breast size
- Hot flashes
- Vaginal dryness
- Mood swings
- Decreased interest in sex
- Insomnia (not being able to sleep)
If you think you have POI, talk to your
health care provider since other medical conditions may cause the same
or similar symptoms.
How is POI diagnosed?
Your doctor can find out if your ovaries are working by
doing a simple blood test to check two hormone levels, FSH and estrogen.
Sometimes it's necessary to repeat the blood test to figure out the
average number or level. High levels of FSH and low levels of estrogen
in a blood test usually mean that you have ovarian insufficiency.
Why are the hormones FSH and Estrogen so important?
In menstruating women, the pituitary gland in the brain
can sense if the ovaries are making the right amounts of estrogen. If a
woman is not getting her period and there is no estrogen being made, the
pituitary gland in the brain will release a hormone called the
follicle-stimulating hormone (FSH). This hormone sends a signal to the
ovaries telling them to start making estrogen.Your ovaries should respond to this signal and begin to release estrogen. When the estrogen is released, the pituitary gland then stops sending out FSH and the level of FSH in your blood stream lowers. However, if you have POI, your ovaries can't make estrogen so the amount of FSH in your blood stays very high.
Is POI permanent?
POI can be unpredictable. After treatment for cancer, you
may or may not get back regular menstrual cycles and ovarian function.
It is possible to have POI after cancer treatment but later have your
ovaries return to making hormones and possibly eggs. Unfortunately,
there is no available test at this time for health care providers to
tell for sure if POI will be permanent.
How is POI treated?
The treatment for POI is to replace the hormones your
body is no longer making. The name for this type of treatment is called
hormone replacement therapy, or HRT. The hormones that need to be
replaced are estrogen, progesterone or both. These hormones are
necessary for breast development, menstrual periods, and healthy bones.
How do you take HRT?
There are different types of HRT. HRT is available as pills, skin patches, and shots.
Pills are usually the easiest type of HRT for young women to take,
although some women prefer using patches that are applied to the skin
once or twice a week. A vaginal hormonal ring is another option. Birth
control pills are often used as an HRT because they contain estrogen and
progesterone.Although HRT may help to replace the hormones that your ovaries don't make anymore, there is no way to replace your eggs if they have been damaged by cancer treatment.
What are the effects of Hormone Replacement Therapy (HRT)?
Your breasts may increase in size if they have not
finished growing. You may start having menstrual periods if your uterus
is healthy. You may get PMS, menstrual cramps, irregular menstrual
periods, or mood swings, just like you would if your body was making the
progesterone and/or estrogen.If you are having any side effects from the HRT, it is important to discuss them with your health care provider. There are many different types of HRT, and your provider can work with you to find the one that is best for you.
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