Dr. Greene, my child had an ultrasound done that showed ovaries and a uterus, but now she has been seen by a specialist, and her ovaries did not show up. My daughter is only 17 years old. What is your thought on this?

Six known categories of insults can destroy the ovaries of a young woman. Some of them are reversible; some of them are not.

One in 10,000 women between the ages of 15 and 29 years experience premature permanent ovarian failure. Menopause at only 17! What a blow for your daughter. Unless something changes, she will never leave descendants to carry her life forward through the generations. Her body will begin to age at a faster pace. Postmenopausal complications are accelerated (osteoporosis, heart disease, wrinkles, dryness, sagging breasts, diminished sex drive...).

Adolescence is a time for connecting with others. It is also a season of intense body image concerns. Going through menopause as a teen can leave a young woman feeling abnormal, isolated, and empty. And teens can't yet perceive the full journey of life, so she can't really know all that she is missing... But you, as her mom, know the depth of what she could miss throughout her life; you feel the loss. Perhaps she will never know the sweet ache of motherhood or the exalted joy of being a grandmother.

What could have destroyed her ovaries? Is this permanent? Can it be corrected? Let’s take a look at some possible causes.

Toxins

The damage from chemicals or radiation can devastate the ovaries. Most often this is a side effect of the treatment of a serious illness. This can be permanent -- but not always. I recently read about a 14-year-old girl who needed intense chemotherapy for a nasty cancer. Her ovaries vanished, and lab tests confirmed that this would likely be permanent, which is why it took more than four months for her to think about getting a pregnancy test when she became pregnant at age 22! Her ovaries quietly began functioning again on their own.

Genetics

As many as 30% of teens with ovarian failure have an underlying chromosome problem. Turner syndrome is the most common problem, but many small defects in the X chromosome can cause ovarian failure -- as can a number of rarer conditions. Any girl with vanishing ovaries must have a chromosome test and a FISH (fluorescent in situ hybridization) test to look for chromosome problems. Rarely, even a male Y chromosome is found in an otherwise normal girl.

Autoimmune Diseases

In several autoimmune diseases, a girl's body can begin to make antibodies that attack the ovaries. This is most common in girls with Addison disease, diabetes, and various thyroid diseases, but can also occur in those with lupus, hypoparathyroidism, adrenal insufficiency, and a number of other autoimmune diseases. The more glands that are involved, the more likely it is that the ovaries will be affected by these antibodies. Young women with ovarian failure should be tested for autoimmune diseases. It is possible for medication to block the antibodies allowing ovarian function to return.