primary ovarian failure

Etiology

• Turner's syndrome
• fragile X syndrome
• hypothyroidism

Clinical manifestations

• apparently menarche may occur
• amenorrhea

Laboratory

• serum FSH & serum LH high
  • elevated serum FSH x 2 = primary ovarian failure
• serum estradiol low
• thyroid function testing*
• karyotyping if no etiology of ovarian failure is apparent

* first tests after primary ovarian failure confirmed

Management

• hormone replacement therapy (oral or transdermal) may mitigate symptoms of hypoestrogenism, reduce risks for osteoporosis, & urogenital atrophy & improve quality of life
• low bone mass should be managed first with hormone therapy, not bisphosphonates.
• contraception
  • combined hormonal contraceptives are more effective than hormone therapy to prevent pregnancy
  • levonorgestrel intrauterine device
• treatment should be continued until the average age of menopause, 50-51 years

More general terms

• ovarian failure

Additional terms

• menopause
• premature ovarian failure (premenopausal anovulation)