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Primary ovarian insufficiency (POI) in girls
Primary ovarian insufficiency (POI) is a rare condition where young girls and teenagers prematurely reach menopause.
What is primary ovarian insufficiency (POI) in girls?
Menopause is the natural decline of reproductive hormones that impacts women around age 50. Young girls with POI will have a decline in the reproductive hormones early and thus can have irregular and then absent menstrual cycles. For some girls, the periods never start.
It can affect emotional and physical health and a girl’s overall well-being. POI causes low estrogen (primary female sex hormone) levels, which can lead to osteoporosis (poor bone strength) and heart disease.
What are the signs and symptoms of primary ovarian insufficiency (POI) in girls?
Symptoms of POI can include:
- Absence of menstrual cycles
- Hot flashes (more common in adults)
- Mood swings
- Night sweats
- Trouble sleeping
- Vaginal dryness
- Weaker bones or osteoporosis
How is primary ovarian insufficiency (POI) in girls diagnosed?
The first step in diagnosis is bloodwork. The patient’s health care provider will help determine what tests are best for the patient to assess for this condition.
What are the causes of primary ovarian insufficiency (POI) in girls?
The exact cause of most cases of POI is unknown. However, it can also occur as a result of a known condition, such as those noted below.
Risk factors
- Celiac disease – Nutrient deficiencies and lower levels of key hormones can trigger POI.
- Chemotherapy or radiation – These treatments can sometimes damage the ovaries, leading to POI.
- Environmental conditions – Triggers like cigarette smoke, pesticides and viruses related to autoimmune diseases have been linked to, but not shown to directly cause, POI.
- Family history – Girls with family members who have the disease are more likely to have POI, but they are not guaranteed to get it.
- Fanconi anemia – This rare disease is inherited (passed down through generations) and is the most common form of aplastic anemia.
- Fragile X syndrome – This inherited (passed down through generations) disease causes intellectual and developmental disabilities in both boys and girls.
- Galactosemia – This disorder affects how the body processes galactose (a simple sugar).
- Turner syndrome – A rare condition caused by the complete or partial absence of one of the two X chromosomes.
- Thyroid disease – This includes too high (hyperthyroidism) or too low thyroid levels (hypothyroidism) that can lead to an imbalance of hormones and POI.
How is primary ovarian insufficiency (POI) in girls treated?
POI is treated with replacement of hormones that the patient’s ovaries are no longer making. Your health care provider will help determine which type of hormonal treatment is best for each patient.
Primary ovarian insufficiency (POI) in girls doctors and providers
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Nirupama De Silva, MD Pediatric Gynecologist -
Jason Jarin, MD Pediatric Gynecologist