Premature Ovarian Failure

Premature ovarian failure is a clinical condition, which occurs in 1% of women aged 40 and over, and is often characterised by amenorrhea or oligomenorrhea, in creased levels of go nadotropic hormones, and decreased estrogen levels. The etiology is usually left unclear, but the genetic, autoimmune, infectious, jatrogenic factors that influence the development of this disease are determined. Pathogenetically, premature follicular depletion or dysfunction is most important. In most cases, women complain about the irregularity or disappearance of menstruation, about infertility, and some suffer from estrogen deficiency. The diagnosis is based on clinical history, symptomatology, laboratory tests (follicle-stimulating and luteinising hormone tests, estradiol, the level of Anti-Mullerian hor­mone in the blood serum), ultrasound examination; for the clarification of ethiology some methods are used: genetic and thyrotropic hormone tests, free thyroxine in the blood serum, proactin and various tests for antibodies, DEXA method for bone mineral density is applied to search for complications. Differentiation should be made from pregnancy as well as from anatomical abnormalities of the hypothalamus-pituitary gland, endocrine, jatrogenic, and reproductive organs. A treatment with hormone replacement therapy, contraception, calcium, and vitamin D supplements for the prevention of complications is prescribed. Psychological help is also suggested, because usually women’s emotional health after the diagnosis becomes disrupted. During primary ovarian failure, women have an occasional ovulation and the pregnancy probability remains, otherwise artificial insemination is used or alternatives are sought, such as the possibility of adoption. If the disease is not treated it increases the risk of es tro gen de ficiencyrelated complications such as osteoporosis, bone regularly and, if necessary, the treatment should be adjusted.