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Your pituitary gland is a pea-sized gland at the base of your brain. The pituitary is the "master control gland" - it makes hormones that affect growth and the functions of other glands in the body.

With pituitary disorders, you often have too much or too little of one of your hormones. Injuries can cause pituitary disorders, but the most common cause is a pituitary tumor.

Primary ovarian insufficiency (POI), also known as premature ovarian failure, happens when a woman's ovaries stop working normally before she is 40.

Many women naturally experience reduced fertility when they are about 40 years old. They may start getting irregular menstrual periods as they transition to menopause. For women with POI, irregular periods and reduced fertility start before the age of 40. Sometimes it can start as early as the teenage years.

POI is different from premature menopause. With premature menopause, your periods stop before age 40. You can no longer get pregnant. The cause can be natural or it can be a disease, surgery, chemotherapy, or radiation. With POI, some women still have occasional periods. They may even get pregnant. In most cases of POI, the cause is unknown.

In about 90% of cases, the exact cause of POI is unknown.

Research shows that POI is related to problems with the follicles. Follicles are small sacs in your ovaries. Your eggs grow and mature inside them. One type of follicle problem is that you run out of working follicles earlier than normal. Another is that the follicles are not working properly. In most cases, the cause of the follicle problem is unknown. But sometimes the cause may be:

• Genetic disorders such as Fragile X syndrome and Turner syndrome
• A low number of follicles
• Autoimmune diseases, including thyroiditis and Addison disease
• Chemotherapy or radiation therapy
• Metabolic disorders
• Toxins, such as cigarette smoke, chemicals, and pesticides

Certain factors can raise a woman's risk of POI:

• Family history. Women who have a mother or sister with POI are more likely to have it.
• Genes. Some changes to genes and genetic conditions put women at higher risk for POI. For example, women Fragile X syndrome or Turner syndrome are at higher risk.
• Certain diseases, such as autoimmune diseases and viral infections
• Cancer treatments, such as chemotherapy and radiation therapy
• Age. Younger women can get POI, but it becomes more common between the ages of 35-40.

The first sign of POI is usually irregular or missed periods. Later symptoms may be similar to those of natural menopause:

• Hot flashes
• Night sweats
• Irritability
• Poor concentration
• Decreased sex drive
• Pain during sex
• Vaginal dryness

For many women with POI, trouble getting pregnant or infertility is the reason they go to their health care provider.

Since POI causes you to have lower levels of certain hormones, you are at greater risk for other health conditions, including:

• Anxiety and depression. Hormonal changes caused by POI can contribute to anxiety or lead to depression.
• Dry eye syndrome and eye surface disease. Some women with POI have one of these eye conditions. Both can cause discomfort and may lead to blurred vision. If not treated, these conditions can cause permanent eye damage.
• Heart disease. Lower levels of estrogen can affect the muscles lining the arteries and can increase the buildup of cholesterol in the arteries. These factors increase your risk of atherosclerosis (hardening of the arteries).
• Infertility.
• Low thyroid function. This problem also is called hypothyroidism. The thyroid is a gland that makes hormones that control your body's metabolism and energy level. Low levels thyroid hormones can affect your metabolism and can cause very low energy, mental sluggishness, and other symptoms.
• Osteoporosis. The hormone estrogen helps keep bones strong. Without enough estrogen, women with POI often develop osteoporosis. It is a bone disease that causes weak, brittle bones that are more likely to break.

To diagnose POI, your health care provider may do:

• A medical history, including asking whether you have relatives with POI
• A pregnancy test, to make sure that you are not pregnant
• A physical exam, to look for signs of other disorders which could be causing your symptoms
• Blood tests, to check for certain hormone levels. You may also have a blood test to do a chromosome analysis. A chromosome is the part of a cell that contains genetic information.
• A pelvic ultrasound, to see whether or not the ovaries are enlarged or have multiple follicles

Currently, there is no proven treatment to restore normal function to a woman's ovaries. But there are treatments for some of the symptoms of POI. There are also ways to lower your health risks and treat the conditions that POI can cause:

• Hormone replacement therapy (HRT).HRT is the most common treatment. It gives your body the estrogen and other hormones that your ovaries are not making. HRT improves sexual health and decreases the risks for heart disease and osteoporosis. You usually take it until about age 50; that's about the age when menopause usually begins.
• Calcium and vitamin D supplements. Because women with POI are at higher risk for osteoporosis, you should take calcium and vitamin D every day.
• In vitro fertilization (IVF). If you have POI and you wish to become pregnant, you may consider trying IVF.
• Regular physical activity and a healthy body weight.Getting regular exercise and controlling your weight can lower your risk for osteoporosis and heart disease.
• Treatments for associated conditions. If you have a condition that is related to POI, it is important to treat that as well. Treatments may involve medicines and hormones.

NIH: National Institute of Child Health and Human Development

Infertility means not being able to get pregnant after at least one year of trying (or 6 months if the woman is over age 35). If a woman keeps having miscarriages, it is also called infertility. Female infertility can result from age, physical problems, hormone problems, and lifestyle or environmental factors.

Most cases of infertility in women result from problems with producing eggs. In primary ovarian insufficiency, the ovaries stop functioning before natural menopause. In polycystic ovary syndrome (PCOS), the ovaries may not release an egg regularly or they may not release a healthy egg.

About a third of the time, infertility is because of a problem with the woman. One third of the time, it is a problem with the man. Sometimes no cause can be found.

If you think you might be infertile, see your doctor. There are tests that may tell if you have fertility problems. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technologies. Happily, many couples treated for infertility are able to have babies.

Dept. of Health and Human Services Office on Women's Health

Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including:

• Growth and development
• Metabolism - how your body gets energy from the foods you eat
• Sexual function
• Reproduction
• Mood

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands, and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones are powerful. It takes only a tiny amount to cause big changes in cells or even your whole body. That is why too much or too little of a certain hormone can be serious. Laboratory tests can measure the hormone levels in your blood, urine, or saliva. Your health care provider may perform these tests if you have symptoms of a hormone disorder. Home pregnancy tests are similar - they test for pregnancy hormones in your urine.

Menopause is the time in your life when you stop having your period and can no longer get pregnant. You have reached menopause when you have not had a period for 12 months.

The time leading up to menopause is called the menopausal transition, or perimenopause. This transition usually begins in when you are in your 40s, but sometimes it can start earlier. It can last for several years. The most common age for reaching menopause is between 45 and 55 years old.

Early, or premature menopause happens when your ovaries stop making hormones and periods stop before age 40. This can happen on its own (with no known cause). It can also happen because of surgery to remove the ovaries or uterus. Medical treatments such as chemotherapy or hormone therapy to treat breast cancer may also cause early menopause.

A condition called primary ovarian insufficiency (POI) happens when your ovaries stop working normally before you are age 40. But this condition is different from early menopause. If you have POI, you may still have periods, even though they might not come regularly. And you might still be able to get pregnant.

During the menopausal transition, your ovaries start to make less of the estrogen and progesterone hormones. The changes in these hormones cause the symptoms of menopause, which can include:

• A change in your periods; they may be:
  • Irregular, with more or less time in between periods.
  • Shorter or longer.
  • Lighter or heavier.
• Hot flashes, a sudden warm feeling in your face, neck, and chest. They may cause you to sweat. If they happen at night and cause sweating, they are called night sweats.
• Trouble sleeping, such as trouble falling asleep or getting back to sleep when you wake up. Over time, a lack of sleep can lead to fatigue and memory problems.
• Vaginal dryness, which may cause pain or discomfort during sexual intercourse.
• Mood changes, which can make you feel moody, anxious, or more irritable.
• Bladder issues, such as urinary incontinence (loss of bladder control) and urinary tract infections (UTIs).

You may also have other physical changes which could put you at risk for certain diseases. For example, the loss of estrogen can:

• Cause you to lose bone density. This can lead to osteoporosis, a condition that causes bones to become weak and break easily.
• Raise your cholesterol levels and increase your risk of heart disease and stroke.

You may not need treatment for the symptoms of menopause. But if you do, there are several different types of treatments:

You may find that you can manage your symptoms with lifestyle changes. Here are some changes that might make you feel better:

• If you have hot flashes, dress in layers that can be removed at the start of a hot flash. You may want to carry a portable fan to use when you get a hot flash.
• Avoid alcohol, spicy foods, and caffeine. They can make your menopause symptoms worse.
• If you smoke, try to quit, not only for hot flashes, but for your overall health.
• Try to maintain a healthy weight. Being overweight or having obesity can make hot flashes worse.
• Have good sleep habits. Keep your bedroom dark, quiet, and cool.
• Get regular exercise. It can help you sleep better, improve your mood, and help lower your risk for many age-related diseases.
• Lower stress, for example by using relaxation techniques such as meditation, deep breathing, and muscle relaxation exercises.

If lifestyle changes are not enough to improve your symptoms, you may want to contact your health care provider. They will talk to you about your symptoms, family and medical history, and preferences. They also can explain the risks and benefits of the treatments.

There are various non-hormone treatments for menopause symptoms, such as:

• Medicines for hot flashes, including certain antidepressants, a medicine just for hot flashes, an antiseizure medicine, and a blood pressure medicine. Some of these medicines may also help with sleep problems.
• Medicines for urinary incontinence.
• Medicines to treat or help prevent osteoporosis.
• Low-dose birth control pills for very heavy bleeding or periods that are close together.
• Water-based lubricants to treat vaginal dryness.
• Medicines for painful intercourse that is caused by vaginal changes from menopause.
• Cognitive behavioral therapy (CBT), a type of talk therapy, for trouble sleeping.

Like all medicines, MHT has benefits and risks. Talk with your provider about whether it is safe for you. If you decide to take MHT, your provider may recommend taking the lowest dose that works for the shortest time needed.

There are various products that are marketed for menopause symptoms. They include supplements, herbs, and over-the-counter "natural" hormone creams. There has been research on many of these products. So far, none of them has clearly been shown to be helpful. Also, there is little information on the long-term safety of these products. Some supplements can have harmful side effects or interact with medicines. Check with your provider before you take use any of them.

Menstruation, or period, is normal vaginal bleeding that occurs as part of a woman's monthly cycle. Every month, your body prepares for pregnancy. If no pregnancy occurs, the uterus, or womb, sheds its lining. The menstrual blood is partly blood and partly tissue from inside the uterus. It passes out of the body through the vagina.

Periods usually start between age 11 and 14 and continue until menopause at about age 51. They usually last from three to five days. Besides bleeding from the vagina, you may have:

• Abdominal or pelvic cramping pain
• Lower back pain
• Bloating and sore breasts
• Food cravings
• Mood swings and irritability
• Headache and fatigue

Premenstrual syndrome, or PMS, is a group of symptoms that start before the period. It can include emotional and physical symptoms.

Consult your health care provider if you have big changes in your cycle. They may be signs of other problems that should be treated.

NIH: National Institute of Child Health and Human Development

The ovaries are part of the female reproductive system. They produce a woman's eggs and make female hormones. Ovarian cysts are fluid-filled sacs in or on an ovary. They usually form during ovulation, when the ovary releases an egg. They are usually harmless and go away by themselves. Most women have them sometime during their lives.

Most ovarian cysts are small and don't cause symptoms. Women may not find out that they have them until they have a pelvic exam. If there are symptoms, they may include:

• Pressure
• Bloating
• Swelling
• Pain in the lower abdomen, on the side where the cyst is

If your health care provider finds a cyst, you may be able to wait to see if it gets bigger. You may need surgery if you have pain, are past menopause, or if the cyst does not go away. If a cyst bursts or causes bleeding, you should get medical help right away. Birth control pills can help prevent new cysts.

Rarely, ovarian cysts can become cancerous. This risk increases as you get older.

A health problem that involves ovarian cysts is polycystic ovary syndrome (PCOS). Women with PCOS can have high levels of male hormones, irregular or no periods, and small ovarian cysts.

Dept. of Health and Human Services Office on Women's Health

The ovaries are part of the female reproductive system. Women have two ovaries, one on each side of the uterus. Each ovary is about the size and shape of an almond.

The ovaries produce and store a woman's eggs. During ovulation, an ovary releases an egg. If that egg is fertilized by a sperm, a pregnancy can occur. Ovaries also make the female hormones estrogen and progesterone. When a woman goes through menopause, her ovaries stop making those hormones and releasing eggs.

Problems with the ovaries include:

• Ovarian cancer
• Ovarian cysts and polycystic ovary syndrome
• Primary ovarian insufficiency
• Ovarian torsion, a twisting of the ovary