2.10 Premature Ovarian Insufficiency

Question 1

What hormone levels will you find in premature ovarian failure?

Answer 1

hypogonadotrophic hypogonadism:

• raised LH and FSH
• low oestradiol

Question 2

Causes of premature ovarian insufficiency?

Answer 2

• idiopathic 50%
• iatrogenic (chemo, oophorectomy, radio)
• autoimmune
• genetic (eg family history of turners)
• infections (eg mumps, tuberculosis, CMV)

Question 3

Diagnostic criteria for premature ovarian insufficiency?

Answer 3

<40 yrs
typical menopausal symptoms
elevated FSH

(FSH must be >25IU/L on two occasions 4 weeks apart, can be complicated by hormonal contraception)

Question 4

What are women with premature ovarian insufficiency more at risk of?

Answer 4

• CVD
• stroke
• osteoporosis
• cognitive impairment
• dementia
• Parkinsonism

Question 5

Management of premature ovarian failure?

Answer 5

• COCP
• HRT

(HRT under 50 does not increase breast cancer risk as the hormones are normal at this age)
(higher VTE risk with HRT under 50, use transdermal patches)