Treatment for premature ovarian failure usually focuses on the problems that arise from estrogen deficiency. Your doctor may recommend:
Estrogen therapy. To help prevent osteoporosis and relieve hot flashes and other symptoms of estrogen deficiency, your doctor may recommend estrogen therapy to compensate for the estrogen your ovaries no longer produce. Estrogen is typically prescribed with another hormone called progesterone. Adding progesterone protects the lining of your uterus (endometrium) from precancerous changes caused by taking estrogen alone. The combination of hormones may cause vaginal bleeding again, but it won't restore ovarian function. Depending on your health issues and personal choice, you may continue taking hormonal therapy until around age 50 or 51 — the average age of natural menopause.
In older women, long-term estrogen plus progestin therapy has been linked to an increased risk of heart and blood vessel (cardiovascular) disease and breast cancer. In young women with premature ovarian failure, however, the benefits of hormone replacement therapy for heart health may outweigh the potential risks.
Calcium and vitamin D supplements. Both calcium and vitamin D are important for preventing osteoporosis. If you don't get enough of them through your diet, your doctor may recommend supplements. Your doctor may suggest bone density testing before starting supplements to get a baseline bone density measurement.
For women ages 19 through 50, the Institute of Medicine recommends 1,000 milligrams (mg) of calcium a day through food or supplements, increasing to 1,200 mg a day for women age 51 or older. Scientists don't yet know the optimal daily dose of vitamin D. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. If your blood levels of vitamin D are low, your doctor may suggest higher doses.
Infertility is a common complication of premature ovarian failure. There's no treatment proved to restore fertility in women with this condition. It's important to understand and grieve for this loss of ovarian function and to seek counseling if you need it.
Some women and their partners choose to pursue a pregnancy through in vitro fertilization using donor eggs. The procedure involves removing eggs from a donor and fertilizing them with your partner's sperm in a lab. The fertilized egg (embryo) is then placed in your uterus. During this process, you take medication that balances your hormones to support a pregnancy. Once the pregnancy is established, you stop taking the medication and the pregnancy proceeds naturally to the delivery.
Feb. 12, 2014
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- Coddington CC (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 16, 2013.
- Questions and answers about estrogen-plus-progestin hormone therapy. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/women/q_a.htm. Accessed Sept. 5, 2013.
- Schierbeck LL, et al. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: Randomised trial. BMJ. 2012;345:e6409.
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