Premature ovarian failure: an arsenal of approaches
Premature ovarian failure (POF) is a term that has acquired particular significance in recent years. It occurs in 1% of women who are under 40 years old. The typical manifestation of this syndrome is episodic or stable hypergonadotropic amenorrhea. It is diagnosed in about 10—28% of women with primary amenorrhea and in 4—18% of women with secondary amenorrhea. Unlike postmenopausal women, many patients with POF ovulate intermittently; there is resumption of regular periods in some cases; and spontaneous pregnancy can occur in 5—10%. But in one way or another long-term menstrual irregularities lead to irreversible cessation of ovarian function at a relatively young age, despite the fact that modern treatment approaches, timely diagnosis, and menopausal hormone therapy (MHT) can improve a woman's quality of life at the present time. This paper discusses the theoretical and practical aspects of the diagnosis and etiological features of POF, highlights key issues and choice of approaches to managing patients with POF in order to correct the symptoms of estrogen deficiency, to possibly restore fertility and minimize cardiometabolic risks.Dubrovina S.O., Aleksandrina A.D.
Conclusion: Women with POF need a special approach and specific therapy depending on their future reproductive plans. Timely MHT remains the main way to relieve the symptoms of estrogen deficiency and leads to an improvement in the level of biochemical and functional markers of endothelial dysfunction. This suggests that MHT is first-line therapy in patients with POF contributing to the normalization of the lipid profile and the functional state of the endothelium, and also confirms the need for its mandatory implementation as the primary prevention of cardiovascular diseases in women with POF.
Keywords
premature ovarian failure
amenorrhea
menopausal hormone therapy
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Received 05.03.2022
Accepted 10.03.2022
About the Authors
Svetlana O. Dubrovina, Dr. Med. Sci., Professor, Chief Researcher, Rostov State Medical University, Ministry of Health of Russia; Chief Researcher, Rostov-on-Don Scientific Research Institute of Obstetrics and Pediatrics, +7(863)250-42-00, s.dubrovina@gmail.com, 344012, Russia, Rostov-on-Don, Mechnikova str., 43.Anna D. Aleksandrina, obstetrician-gynecologist, Rostov-on-Don City Emergency Hospital, +7(863)233-67-42, anna221215@inbox.ru,
344068, Russia, Rostov-on-Don, Bodraya str., 88/35.
Authors’ contributions: Dubrovina S.O., Aleksandrina A.D. - an equal contribution to the writing and editing the manuscript. Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The article has been prepared without sponsorship.
For cuitation: Dubrovina S.O., Aleksandrina A.D. Premature ovarian failure: an arsenal of approaches. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 3: 13-20 (in Russian)
https://dx.doi.org/10.18565/aig.2022.3.13-20
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