Premature ovarian failure (POF) is defined by most authors as the loss of ovarian function before the age of 40. It is characterized by amenorrhea, hypoestrogenemia, and elevated serum gonadotropin levels. This occurs in about 1.9% of women before age 40 and in 0.1% of women before age 30. Menopause normally occurs at an average age of 50, at which time ovulation ceases and symptoms of hypoestrogenemia typically appear as a result of ovarian follicular depletion. The mean age of menopause is over 45 in 88% of women and under 45 in 9.7% of women.
When POF occurs, it has been shown that there may be some ovarian follicles remaining, menses may return, and pregnancies may occur. The two primary concerns of the woman and the clinician include the woman's fertility potential and the long-term consequences of hypoestrogenemia. This lecture will present the currently understood causes of POF, a reasonable diagnostic approach to the problem, the long-term health consequences of POF, and therapeutic considerations.
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