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Premature ovarian failure

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Premature Ovarian Failure (POF) affects approximately 1-4% of the female population in the U.S., which is about 150,000 to 600,000 women. Normally, ovaries supply women with eggs until about age 51, the average age of natural menopause. POF is not menopause in that the dysfunction of the ovaries, loss of eggs, or removal of the ovaries at a young age is not a natural physiological occurrence. Infertility is the result of this condition, and is the most discussed problem resulting from it, but there are additional health implications of the problem, and studies are on-going. For example, osteoporosis or decreased bone density affects almost all women with POF due to an insufficiency of estrogen. There is also an increased risk of heart disease, hypothyroidism in the form of Hashimoto’s thyroiditis, Addison’s disease, and other auto-immune disorders for women with POF.

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Premature ovarian failure from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

References


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Historical Perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Historical Perspective

References


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Classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Classification

References


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Pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Pathophysiology

Hormonally, POF is defined by abnormally low levels of estrogen and high levels of FSH, which demonstrate that the ovaries are no longer responding to circulating FSH by producing estrogen and developing fertile eggs. The ovaries will likely appear shriveled. Age of onset can be as early as the teenage years but varies widely. If a girl never begins menstruation, it is called primary ovarian failure. The age of 40 was chosen as the cut-off point for a diagnosis of POF somewhat arbitrarily—as all women’s ovaries decline in function over time, an age needed to be chosen to distinguish usual menopause from the abnormal state of premature menopause. However, premature ovarian failure often has components to it that distinguish it from normal menopause. By the age of 40, approximately one percent of women have POF. Women suffering from POF usually experience menopausal symptoms, which are generally more severe than the symptoms found in older menopausal women.

References


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Differentiating Premature ovarian failure from other Diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Differentiating Premature ovarian failure from other Diseases

Diseases with similar symptoms:

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Epidemiology and Demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Epidemiology and Demographics

References


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Risk Factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Risk Factors

Family history and ovarian or other pelvic surgery earlier in life are implicated as risk factors for Premature ovarian failure.

References


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Screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Screening

References


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Natural History, Complications and Prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Natural History

Complications

Prognosis

Prognosis of most patients with premature ovarian failure may be good with the hormone replacement therapy.

References


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Diagnosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case Studies

Case #1

Related Chapters

Impaired Ovarian Reserve

Premature Menopause

External links

U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, NICHD Information Resource Center, Do I have Premature Ovarian Failure? NIH pub. No. 03-5159, August 2003. You can order free copies by calling 1-800-370-2943, and it’s also available for download at http://www.nichd.nih.gov/publications/pubs/pof/upload/premature_ovarian_failure.pdf

National Institutes of Health/ Premature Ovarian Failure website http://eclipse.nichd.nih.gov/nichd/deb/geuPOF/resources.htm

Current POF Clinical trials via the NIH recruiting patients http://www.clinicaltrials.gov and search “premature ovarian failure”

“What’s The Best Approach To Spontaneous Premature Ovarian Failure?”, by Dr. Lawrence Nelson, Principal Investigator at NIH for POF research studies/clinical trials. http://pof.nichd.nih.gov/Contemp_ObGyn_2004_POF.pdf

Women with premature menopause at increased risk for potentially fatal adrenal condition-early diagnosis can lead to effective treatment, NIH News Release. http://www.nih.gov/news/pr/aug2002/nichd-30.htm. Nelson, L., 2002.

Irregular periods in young women could be warning sign for later osteoporosis, NIH News Release. http://www.nih.gov/news/pr/may2002/nichd-29.htm. Nelson, L., 2002.

References

References


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