Premature ovarian insufficiency Flashcards
What is premature ovarian insufficiency?
menopause before 40 years old
What are some causes of POI?
Idiopathic
Iatrogenic (Chemo, radiotherapy, oophorectomy)
Autoimmune
Genetic
Infections
What are some autoimmune conditions that are associated with POI?
Coeliac disease
Adrenal insufficiency
T1DM
Thyroid disease
What are some infections that can cause POI?
Mumps
TB
CMV
Describe the pathophysiology of POI
Decline in normal ovarian activity
Underactivity of the gonads causing negative feedback on the pituitary gland leading to excess gonadotropins
Hypertrophic hypogonadism
How will POI present?
Irregular menstrual periods
Secondary amenorrhoea
Symptoms of low oestrogen (Hot flushes, night sweats, vaginal dryness)
What will hormonal analysis show in POI?
Low oestradiol levels
Raised LH and FSH
How is POI diagnosed?
Elevated FSH (>25) on 2 consecutive samples >4 weeks apart
What are some conditions with an increased risk in POI?
- Cardiovascular disease
- Stroke
- Osteoporosis
- Cognitive impairment
- Dementia
- Parkinsonism
How is POI managed?
HRT (Tradition or COC)
What are some benefits of traditional HRT in POI
Lower blood pressure
Does not increase breast cancer risk
What are some benefits of COC in POI?
Less stigma for younger women
