Author/Editor     Meden-Vrtovec, Helena
Title     Prijevremena menopauza
Translated title     Premature menopause
Type     članek
Source     Gynaecol Perinatol
Vol. and No.     Letnik 14, št. Suppl 1
Publication year     2005
Volume     str. 33-8
Language     slo
Abstract     Premature ovarian failure (POF) is diagnosed as the presence of at least 4 months of amenorrhea and two FSH values greater than 40 mIU/ml in the period of at least one month apart in a woman aged less than 40 years. POF is a rare condition, affecting one in 1,000 women between the age of 15 and 29, or one in 100 women aged 30-39 years. Etiology cannot always be established. A dominant cause of POF is autoimmunity, including autoimmune lymphocytic oophoritis and autoimmune polyglandular syndrome. It can also be caused by gonadotropin and gonadotropin receptor abnormalities. Chromosomal abnormalities are detected in 40-50% of women with POF. Iatrogenic factors are rare and include repetitive surgeris for chronic ovarian disease and infiltrative benign conditions. Of the diagnostic procedures karyotyping and the tests for autoimmune disorders (FSH, free thyroxine, fasting glucose) should be performed in all patients with POF. Timely recognition of some warning signs of POF are of utmost importance: changes in menstrual cyclicity and shortening of the cycle, variability of FSH and estradiol (E2), long term amenorrhea after oral contraception withdrawal. A screening test for POF should be performed in high-risk patients: infertile women over 35 years with unexplained infertility, ovarian endometriosis, single ovary, family history of early menopause, previous chemotherapy. Passive screening tests include day 3 determination of FSH, inhibin B, E2 and anti-Mullerian hormone; and dynamic tests are: gonadotropin-releasing hormone agonist stimulation test, clomiphene-citrate challenge test and measurement of mean count of antral early follicular phase follicles together with mean ovarian volume. Management of POF includes hormonal replacement therapy until the age of natural menopause; androgen replacement should be considered in women with fatigue and low libido. (Abstract truncated at 2000 characters)
Descriptors     MENOPAUSE, PREMATURE
OVARIAN FAILURE, PREMATURE
AMENORRHEA
FSH
ESTRADIOL
KARYOTYPING
INHIBIN
CLOMIPHENE