Common symptoms of premature ovarian failure

Common symptoms of premature ovarian failure include abnormal menstruation, hot flashes and night sweats, mood swings, vaginal dryness, and infertility. Premature ovarian failure refers to the decline of ovarian function in women before the age of 40, which may be related to genetic, immune, iatrogenic injury and other factors.

1. Abnormal menstruation

Prolonged or shortened menstrual cycles, reduced menstrual flow or even amenorrhea are core manifestations of premature ovarian failure. Due to insufficient follicular reserve or premature depletion, estrogen levels drop, causing the endometrium to fail to proliferate and shed normally. Some patients may first experience oligomenorrhea and then develop persistent amenorrhea. Accompanying symptoms include breast atrophy and loss of libido, and ovarian reserve function needs to be evaluated through six hormone tests and ultrasound.

2. Hot flashes and night sweats

Hot flashes caused by vasomotor dysfunction usually start on the face and spread throughout the body, lasting several minutes each time. Hot flashes may be accompanied by profuse sweating at night. This is related to estrogen deficiency affecting the hypothalamic temperature regulation center, and about 75% of patients will experience this symptom. The attack may be accompanied by palpitations and dizziness, which may be aggravated by elevated ambient temperatures or emotional stress.

3. Mood swings

Sudden drops in estrogen levels can lead to disruptions in neurotransmitters such as serotonin, which can manifest as anxiety, depression, irritability, or difficulty concentrating. Some patients have symptoms similar to perimenopausal syndrome, such as sleep disorders and memory loss, and psychological evaluation shows that depression scale scores are significantly increased.

4. Vaginal dryness

Estrogen deficiency causes vaginal mucosa to become thinner, wrinkles to decrease, and insufficient secretions to cause sexual intercourse pain or recurrent urogenital tract infections. The examination showed that the vaginal pH value increased to above 6, and the vaginal epithelial cell maturity index shifted to the left. Long-term unintervention may lead to urethral syndromes such as atrophic vaginitis or frequent urination and urgency.

5. Infertility

Ovulation failure caused by premature follicle depletion is the main cause of decreased fertility. Although some patients ovulate occasionally, the pregnancy rate is less than 5%. Along with anti-Müllerian hormone levels below 1.1 ng/ml, ultrasound showed an antral follicle count of less than 5. Assisted reproductive technology intervention is required, but the number of eggs retrieved and the quality of embryos are usually poor.

After diagnosis of premature ovarian failure, long-term hormone replacement therapy is required. It is recommended to choose natural estrogen such as estradiol valerate tablets combined with dydrogesterone tablets for periodic medication. Daily intake of 800 mg of calcium and 400 IU of vitamin D should be ensured to prevent osteoporosis, and resistance exercise should be performed three times a week to maintain bone density. Avoid smoking and drinking, limit caffeine intake, and regularly monitor breast and endometrium conditions. Psychological counseling and spousal support are particularly important to improve the quality of life.