Premature ovarian failure, also called premature ovarian insufficiency or premature menopause, is a disorder characterized by menopause at an age earlier than 40. In most cases, the cause of POI is never determined. This can be caused by a smaller number of ovarian follicles at birth, increased decline of follicles, or the dysfunction of follicles. It is diagnosed by a lack of a period (amenorrhea) for more than 4 months and elevated FSH levels.
There is been controversy about whether the HPV quadrivalent vaccine, Gardasil can cause premature ovarian failure in adolescents or young women. The Vaccine Adverse Reporting System (VAERS) has over 200 reports of premature ovarian insufficiency as a result of the HPV vaccines. However, the VAERS system is a subjective self-reporting system. Even if correlation is reported, it does not prove causation.
There was also a small case study of 3 adolescent girls that experienced premature ovarian failure shortly after administration of the vaccine in Australia, whose doctors believe were due to receiving the vaccination.
The HPV vaccine has emerged as a possible cause for an increase in POI, however at this time, there is no solid evidence to that end. Doctors are calling for more studies to be conducted to illuminate this issue. The studies that were reported recently have been criticized for multiple reasons, including the following: assessment of the over 44,000 women was based on emergency room visits and hospitalizations, which is not where POI would present; and the control for many of the studies was actually aluminum hydroxyphosphate sulfate, the controversial adjuvant. There are concerns that AAHS may itself not be safe, so it was a very poor choice for a "placebo" control.
All of that being said, in my opinion there is not enough evidence as to whether the HPV vaccine could cause POI. I look at every intervention as a matter of risk to benefit ratio. Does the potential benefit outweigh the risks? Every person is different, however, I believe that for most of my patients, the benefit does not outweigh the risk of this vaccine.
Here is why:
- Low gradecervical dysplasias have a 95% chance of clearing on their own (according to a 2002 UCSF study).
- It takes years for most cervical dysplasias and cancers to develop, so with regular PAPs, we can catch virtually all of them before they become major problems.
- In Naturopathic Medicine, we know of many treatments for cervical dysplasias to help them clear.
- With the advent of even better testing (co-testing with HPV) we can know about even more potential cases for cervical dysplasias.
- We have well studied and proven treatments for cervical dysplasias in the conventional medical system.
- We do not currently have enough safety information on the vaccines, and more studies should be preformed on the vaccine.
*Please note that this article was edited for clarity.
Dr. Jen Riegle is a Naturopathic Doctor (ND) who practices in Santa Rosa, CA. Dr. Jen specializes in women's health, infertility, and oncofertility. If you live in the Bay Area and would like to make an appointment, you may schedule on our website or by calling (707)-243-8998.