Premature ovarian insufficiency (POI) refers to a decline in ovarian function in women before the age of 40, primarily manifested as infrequent menstruation or amenorrhea for at least 4 months (menstrual abnormalities include amenorrhea, irregular or frequent menstruation, shortened cycle, reduced flow, and irregular cycles), elevated levels of gonadotropins (FSH > 25 U/L, with a 4-week interval between two tests), fluctuating low estrogen levels, and reduced fertility or infertility.
POI may occur suddenly, with the symptom being a sudden halt of the menstrual cycle.
The onset of POI may also be a gradual process, with several months of menstrual irregularities occurring before amenorrhea. Most patients with POI experience symptoms similar to those of women who typically enter menopause. These symptoms may include hot flashes, irritability, night sweats, and sleep disturbances.
Young women with POI may never have menstrual cycles or may not go through a normal puberty phase. For other women, earlier signs of premature ovarian aging may include difficulties in conceiving. The appearance of these symptoms is often due to low estrogen levels caused by ovarian insufficiency. Premature ovarian insufficiency can also expedite the use of assisted reproductive technologies.
The reasons for decreased ovarian reserve function include the following:
1. Genetic and immune factors
Genetic factors such as chromosomal abnormalities and mutations lead to a lower quantity and quality of follicles compared to women with normal function. Certain autoimmune diseases, such as Hashimoto’s thyroiditis, systemic lupus erythematosus, and rheumatoid arthritis, can also result in decreased ovarian reserve function.
2. Ovarian damaging factors
Ovarian surgeries such as oophorectomy, cystectomy, and tubal ligation can damage the ovarian reserve function to varying degrees. Radiotherapy and chemotherapy may also impair ovarian function, leading to a decrease in reserve capacity. Viral mumps orchitis in children and adolescents can lead to partial or total loss of ovarian function; severe pelvic inflammatory disease can also damage ovarian tissue, resulting in decreased ovarian reserve function.
3. Environmental factors
Therefore, staying away from adverse environments is generally more conducive to pregnancy.
