premature ovarian failure (premenopausal anovulation)
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Introduction
Cessation of ovarian function under the age of 40 years
Etiology
- chemotherapy induced ovarian failure in survivors of childhood malignancies, especially alkylating agents
- autoimmune disease
- genetic forms (see genetics)
Epidemiology
- accounts for 10-20% of women with amenorrhea
Genetics
- deletions in the long arm of chromosome X
- associated with defects in FOXL2 gene (POF3)
- associated with defects in POF1B (POF2B)
- associated with defects in DIAPH2 (type 2A)
- associated with defects in GDF9B (BMP15) (type 4)[2]
- associated with isoform CSB-PGBD3 of the chimeric protein ERCC6-PGBD3
Clinical manifestations
- amenorrhea
- before age 40
- may be intermittent in early phases
- hot flashes
- breast tenderness
- hypoestrogenism
- early menopause
Laboratory
- elevated levels of serum FSH, serum LH
- isolated increases in serum FSH in early phases
- serum estradiol is low
Management
- estrogen replacement (hormone replacement therapy)
- may be indicated for women with permanent ovarian failure
- NOT a reliable contraceptive
- NOT useful for fertility treatment
- chemotherapy-induced premature ovarian failure is not a contraindication[1]
- 10 mg medroxyprogesterone acetate for 10 days every other month to prevent endometrial hyperplasia
More general terms
Additional terms
References
- ↑ 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 17, 19. American College of Physicians, Philadelphia 1998, 2015, 2023
- ↑ 2.0 2.1 OMIM https://mirror.omim.org/entry/300510
- ↑ Cordts EB, Christofolini DM, Dos Santos AA et al Genetic aspects of premature ovarian failure: a literature review. Arch Gynecol Obstet. 2011 Mar;283(3):635-43 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21188402
- ↑ Bakalov VK, Vanderhoof VH, Bondy CA, Nelson LM. Adrenal antibodies detect asymptomatic auto-immune adrenal insufficiency in young women with spontaneous premature ovarian failure. Hum Reprod. 2002 Aug;17(8):2096-100. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12151443 Free Article
- ↑ Belvisi L, Bombelli F, Sironi L, Doldi N. Organ-specific autoimmunity in patients with premature ovarian failure. J Endocrinol Invest. 1993 Dec;16(11):889-92. PMID: https://www.ncbi.nlm.nih.gov/pubmed/8144865
- ↑ de Moraes Ruehsen M, Blizzard RM, Garcia-Bunuel R, Jones GS. Autoimmunity and ovarian failure. Am J Obstet Gynecol. 1972 Mar;112(5):693-703. PMID: https://www.ncbi.nlm.nih.gov/pubmed/4551032
- ↑ Hoek A, Schoemaker J, Drexhage HA. Premature ovarian failure and ovarian autoimmunity. Endocr Rev. 1997 Feb;18(1):107-34. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/9034788
- ↑ Kauffman RP, Castracane VD. Premature ovarian failure associated with autoimmune polyglandular syndrome: pathophysiological mechanisms and future fertility. J Womens Health (Larchmt). 2003 Jun;12(5):513-20. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12869299
- ↑ Mignot MH, Schoemaker J, Kleingeld M, Rao BR, Drexhage HA. Premature ovarian failure. I: The association with autoimmunity. Eur J Obstet Gynecol Reprod Biol. 1989 Jan;30(1):59-66. PMID: https://www.ncbi.nlm.nih.gov/pubmed/2647538
Mignot MH, Drexhage HA, Kleingeld M et al Premature ovarian failure. II: Considerations of cellular immunity defects. Eur J Obstet Gynecol Reprod Biol. 1989 Jan;30(1):67-72. PMID: https://www.ncbi.nlm.nih.gov/pubmed/2647539 - ↑ Moncayo-Naveda H, Moncayo R, Benz R, Wolf A, Lauritzen C. Organ-specific antibodies against ovary in patients with systemic lupus erythematosus. Am J Obstet Gynecol. 1989 May;160(5 Pt 1):1227-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/2729399
- ↑ 11.0 11.1 Ryan MM, Jones HR Jr. Myasthenia gravis and premature ovarian failure. Muscle Nerve. 2004 Aug;30(2):231-3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15266640
- ↑ Clines GA. Mechanisms and treatment of hypercalcemia of malignancy. Curr Opin Endocrinol Diabetes Obes. 2011 Dec;18(6):339-46. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/2189722
- ↑ Legrand SB. Modern management of malignant hypercalcemia. Am J Hosp Palliat Care. 2011 Nov;28(7):515-7. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21724679