March 20, 2004
Other
Question from Guelph, Ontario, Canada:
I am hoping you can elaborate on the link between premature ovarian failure (POF) and type 1 diabetes. I am 19 and have had diabetes for five and a half years with relatively good control. My highest A1c has been 8.8 and that was brought down by the next appointment. I currently use an insulin pump. Ever since my diagnosis, at fourteen, I have never had periods. I had one when I was thirteen, but have never had a natural one since. I had hormonal tests done about three years ago, and was not really told what the results were. I was then put on the birth control pill, marvelon, with the hope that it would “kick start” everything. I have just switched to an adult clinic and decided, with my doctor, in December to go off the pill to see what happens. So far, nothing has happened, and I have started browsing the internet for possible reasons why, and keep running into the fact that POF is linked with autoimmune diseases. What, if any, tests should my doctor conduct when I see her in April? Is this a legitmate concern at this point, or am I overreacting? Approximatley how many women with type 1 are affected by this?
Answer:
Polyendocrine deficieny syndromes do exist. They represent a condition where more than one endocrine gland is affected by the body’s immune system. In addition to the endocrine pancreas and ovary, the thyrid, adrenals, gastric lining (causing pernicious anemia), and skin (causing vitiligo) can be affected. It is important that you discuss this with your physician so that approrpriate screening tests can be conducted. The frequency of these conditions occurring together are still uncommon. Your doctor will have to work through the possibilities before it is confirmed you have premature ovarian failure.
JTL
Additional comments from Dr. Bill Jones:
This is a problem outside my usual area of expertise. However, there are some simple tests that can be done to determine if your ovaries are working. Your doctor can check a follicle stimulating hormone (FSH) level. In women with premature ovarian failure, essentially menopause, this will be very high. There are other causes of lack of periods such as major weight change, thyroid disorders and pregnancy. So, several items should be checked.
OWJ
