Review

A practical guide for managing young women with primary ovarian insufficiency

Drakakis Peter1, Tzouma Christina2, Dalkalitsis Alexander3, Calis Karim4, Kalantaridou Sophia2

11st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
22nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
3Department of Obstetrics and Gynecology, University of Ioannina, School of Medicine, Ioannina, Greece
4Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Building 31, Suite 2A25, Room 2A25E, 31 Center Drive (MSC 2423), Bethesda, Maryland 20892, USA; University of Maryland, Baltimore, Maryland, USA

Correspondence: Drakakis Peter, 1st Department of Obstetrics and Gynecology, Alexandra Hospital National and Kapodistrian University of Athens, School of Medicine, 80 Vas. Sofias Avenue, GR-11528 Athens, Greece, E – mail: pdrakakis@hotmail.com


Abstract

Primary ovarian insufficiency (POI) is a condition characterized by sex-steroid deficiency, amenorrhea, infertility, and elevated gonadotropins in women younger than 40 years of age. Most affected women produce estrogen intermittently and may ovulate despite the presence of high gonadotropin concentrations. POI is a heterogeneous disorder and may occur as a result of decreased initial follicle number, ovarian follicle dysfunction or ovarian follicle depletion. In most cases, the etiology cannot be identified. Spontaneous POI is associated with increased risk for hypothyroidism, Addison’s disease and diabetes mellitus. POI increases the risk for osteoporosis and cardiovascular disease. Women with POI need exogenous sex steroids to compensate for the decreased production by their ovaries. Thus, premenopausal hormone therapy is required at least until these women reach the age of natural menopause.

Keywords: primary ovarian insufficiency, management, hormone replacement therapy, infertility

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