Premature Ovarian Insufficiency

Question 1

What is premature ovarian insufficiency?

Answer 1

Onset of menopause in a woman aged below 40 years.

Question 2

What is the aetiology of premature ovarian insufficiency?

Answer 2

Idiopathic or iatrogenic.

Iatrogenic causes include: invasive procedures or treatments such as ovarian surgery, radiotherapy, or chemotherapy that directly impact the ovaries.

Question 3

What are the symptoms of premature ovarian insufficiency?

Answer 3

Vasomotor symptoms: hot flushes, night sweats

Sexual dysfunction: vaginal dryness, reduced libido, problems with orgasm, dyspareunia

Psychological symptoms: depression, anxiety, mood swings, lethargy, reduced concentration

Question 4

What 3 other conditions can present as premature ovarian insufficiency? Differentials

Answer 4

Hypothyroidism: fatigue, weight gain, cold intolerance, depression, hair loss

Hyperprolactinemia: irregular menstrual cycles, infertility, breast milk production not related to childbirth or nursing

Polycystic Ovary Syndrome (PCOS): irregular periods, hirsutism, obesity, infertility

Question 5

How is premature ovarian insufficiency investigated?

Answer 5

FSH testing - must be repeated to confirm the diagnosis and ensure first test was not anomalous.