Premature ovarian insufficiency: evaluation and management

Abstract

Impairment of ovarian function before the age of 40 years is defined as premature ovarian insufficiency (POI). Alteration of normal menstrual pattern is the commonest presentation of POI and two serum follicle stimulating hormone (FSH) measurements in the menopausal range at least a month apart is diagnostic. Once the possibility of pregnancy is excluded, evaluation of POI should include initial laboratory evaluation of FSH, leutinizing hormone (LH), estradiol, serum prolactin and thyroid status. A possible etiology should be determined by karyotyping, screening for FMR1 premutations, testing autoimmune markers such as anti-21 hydroxylase antibodies and imaging with pelvic ultrasonography. Management should address psychological well being, ovarian hormone replacement, and restoration of fertility. Management of associated endocrinopathies, co-morbidity and genetic counseling are also of great relevance.DOI: http://dx.doi.org/10.4038/sjdem.v2i1.4334 Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2012; 2: 39-42

Keywords

• premature ovarian insufficiency
• ovarian hormone replacement
• fertility