Medical Classroom

All women are afraid of "premature ovarian failure"

2018-03-27 07:50:01

One day, my colleagues around the nursing staff rushed to check the AMH (anti-Muller's hormone). After I saw it, I couldn't help but ask them: "What are we worried about?" When they asked, they knew that their anxiety was from "Premature ovarian failure" is probably a guest who has seen too many "premature ovarian failures", so the inner part of the inexplicable projection of a sense of fear, I have a chance to help my colleagues solve their concerns, so I wrote this article.


What is premature ovarian failure?

"20 years old is afraid of pregnancy, 30 years old is afraid of infertility, 40 years old is afraid of premature ovarian failure." Women of every age need to worry about different physiological problems. Eventually, "premature ovarian failure" will be like the big devil in the game, step by step. Approaching modern women, the 40-year-old egg is exhausted and goes to menopause.

Dean Zhong Jixian: "Normal women's ovarian function begins to decline after 37 years of age, and premature ovarian failure refers to women with regular menstruation. Before the age of 40, persistent amenorrhea and atrophy of the organs due to ovarian function decline." Ovarian atrophy and persistent amenorrhea And atrophy of the sexual organs (such as uterine atrophy, vaginal folds, vulvar atrophy, etc.), accompanied by a decline in estrogen levels.


Do you know that in daily life, many intangible causes can lead to premature ovarian failure? Women must remember the following 6 points that may cause premature ovarian failure and stay away from them:

1. Environmental pollution: Because the ovaries are very sensitive group 1. Environmental pollution: Because the ovaries are very sensitive tissues, they are easily damaged. If they are often exposed to radiation, ovarian function declines earlier, such as pesticides, plasticizers, and chemical treatments caused by cancer.

2. Immune disease: In women with autoimmune diseases, the immune system in the body is problematic. The immune system in the body often mistakenly destroys the germ cells in the ovarian tissue as foreign objects.

3. Viral bacterial infection: Some women are infected with mumps virus infection and ovarian inflammation or pelvic cavity infection at an early age, recurrent ovarian inflammation, destroying ovarian function, making the ovary insensitive to gonadotropin stimulation of the pituitary gland, not producing due The reaction, the occurrence of premature ovarian failure.

4. Stress in life: Excessive psychological stress caused by accelerated life rhythm will cause women to have menopausal symptoms early, may cause physical and mental exhaustion, weight gain, irritability, insomnia, dry skin, menstrual disorders, etc., sometimes tired of work, inexplicable illness Causes premature aging of these female ovaries.

5. Ovarian disease: Partial bilateral or unilateral ovaries due to disease can cause premature ovarian failure due to tissue dysfunction. After ovarian tissue resection, the number of eggs decreases, ovarian function declines, and osteoporosis and menopause occur earlier.

6. Bad habits: Women who do not have exercise habits, smoke, excessive weight loss, and abnormal lifestyle are prone to premature ovarian failure; and the age of women who smoke is 1 to 2 years earlier than those who do not smoke.


Because of the many causes of premature ovarian failure, the symptoms are different. as follows:

1. Amenorrhea: secondary amenorrhea occurs before the age of 40. A large sample of patients with premature ovarian failure found that there were no characteristic signs of menstrual abnormalities before amenorrhea. Some people suddenly amenorrhea after regular menstruation, some stop contraceptives or amenorrhea after childbirth, and some manifest as menstrual cycle and menstrual disorders before amenorrhea.

2. Infertility: Infertility is the main cause of treatment and distress in patients with premature ovarian failure. There are primary infertility and secondary infertility. Dean Zhong Jixian suggested that a family history of premature ovarian failure should plan for pregnancy or oviposition as soon as possible.

3. Low estrogen symptoms: low estrogen symptoms in patients with premature ovarian failure are rare. If they are, most of them are related to estrogen replacement therapy. Secondary estrogen symptoms are common in secondary amenorrhea.

4. Occult symptoms of adrenal insufficiency: This symptom mainly refers to recent weight loss, loss of appetite, abdominal pain, and increased skin pigmentation.

5. Natural recovery of ovarian dysfunction: Premature ovarian failure does not mean complete loss of ovarian function, and transient or intermittent recovery of ovarian function is possible.


Simple ovarian regression assessment formEarly menstrual periods and decreased days of bleeding require more than three cycles in the last six months to make sense, and there is no history of gynecological diseases.

0~5 points means it may be normal
5~10 points indicates possible mild decline
10~15 points indicate possible moderate to severe decline

FSH and follicle number prediction

AMH and follicle number prediction*The form is for reference only and can be more accurately evaluated by on-site diagnosis by a professional physician.


Early signs of ovarian decline

Unexplained "menstrual early" and "menstrual blood loss" are the two most important phenomena. Blood was taken from the menstrual period 1 to 3 days to test AMH and FSH, and vaginal ultrasound was arranged to measure ovarian volume and AFC (small follicle number).

When the AMH is less than 3, the stock is already at a low level, and less than 1 means "severe ovarian decline.The former induces ovulation usually rarely exceeds 5 follicles. The latter usually has only one or two. The closer the AMH is to 0, the closer it is to the ovary. Depletion.

If FSH has a large index error, it needs to be evaluated for 2~3 cycles for reference. FSH greater than 8 is a preliminary recession warning, more than 10 is a severe recession, and 12 or more indicates a very severe recession.