Download fulltext HTML

https://doi.org/10.18502/espoch.v3i1.14483

statistics

  • 200 Abstract Views
  • 88 PDF Views
  • 0 HTML Views

authors

  • E.P. Robles Granda

    E.P. Robles Granda

    Especialista en Gineco-Obstetricia del Hospital Alfredo G. Paulson, Guayaquil-Ecuador
    https://orcid.org/0000-0003-2972-2106
  • F.N. Briones Moreira

    F.N. Briones Moreira

    Especialista en Gineco-Obstetricia del Hospital Alfredo G. Paulson, Guayaquil-Ecuador

Published Date

  • Nov 9, 2023

Premature Ovarian Insufficiency, an important cause of early menopause: Review of the literature with clinical case reports

ESPOCH Congresses: The Ecuadorian Journal of S.T.E.A.M. / Volume 3 Issue 1 / Pages 730–744

Abstract

Early menopause is established by the definitive cessation of menstrual cycles and marks the end of the reproductive stage of women before the age of 40. This condition can be caused by premature ovarian insufficiency (POI) of spontaneous development or external causes, which impairs the reproductive capacity of young women and their quality of life, with medium and long-term consequences such as genitourinary dysfunction, dyslipidemia, insulin resistance, decreased bone mineral density, cardiovascular, cognitive alterations, among others. Its prevalence is around 1% in those under 40 years of age, and the objective of this work is to review important aspects of premature ovarian insufficiency and its relationship with the development of menopause, objectified through the report of 2 significant clinical cases. Case 1: A 26-year-old patient, nulliparous, with amenorrhea from the age of 22 to the current date, with values of FSH and LH, Estradiol, and anti-Müllerian Hormone, compatible with menopause. Case 2: A 30-year-old patient, nulliparous, who at the age of 16 underwent right oophorectomy for immature cystic teratoma, with 6 months of amenorrhea and FSH, LH, Estradiol, and anti- Müllerian hormone values compatible with menopause. Both patients suffered from menstrual irregularities since their menarche, which was evaluated by specialists when the periods of amenorrhea were extensive. This underscores the importance of a timely evaluation of IOP in young people who persist with menstrual disorders after 2 years of menarche, with diagnostic studies and management that help preserve their reproductive health to which they are entitled.


Keywords: Primary ovarian insufficiency, menopause premature, amenorrhea.


Resumen


La menopausia precoz se establece por el cese definitivo de los ciclos menstruales y marca el final de la etapa reproductiva de la mujer antes de los 40 años. Esta condición puede producirse por Insuficiencia Ovárica Prematura (IOP) de desarrollo espontáneo o causas externas, que deteriora la capacidad reproductiva de mujeres jóvenes y su calidad de vida, con consecuencias a mediano y largo plazo como disfunción genito-urinaria, dislipidemias, insulino resistencia, densidad ósea disminuida, alteraciones cardiovasculares, cognitivas, entre otras. Su prevalencia es alrededor del 1% en menores de 40 años, y el objetivo de este trabajo es revisar aspectos importantes de la Insuficiencia ovárica prematura y su relación con la menopausia, objetivado a través del reporte de 2 casos clínicos significativos. Caso 1: Paciente de 26 años, nuligesta, con amenorrea desde los 22 años hasta fecha actual, con valores de FSH y LH, Estradiol y Hormona antimulleriana, compatibles con menopausia. Caso 2: Paciente de 30 años, nuligesta, quien a los 16 años fue operada de ooforectomía derecha por teratoma quístico inmaduro, con 6 meses de amenorrea y valores de FSH, LH, Estradiol y Hormona antimulleriana compatibles con menopausia. Ambas pacientes padecieron de irregularidades menstruales desde su menarquia, lo cual fue evaluado por especialistas cuando los periodos de amenorrea fueron extensos. Esto recalca la importancia de una evaluación oportuna de la IOP en jóvenes que persisten con trastornos menstruales luego de 2 años de menarquia, con estudios diagnósticos y manejo que ayuden a preservar su salud reproductiva a la que tienen derecho.


Palabras Clave: Insuficiencia ovárica primaria, menopausia prematura, amenorrea.

References
[1] Sullivan SD, Sarrel PM, Nelson LM. Hormone replacement therapy in young women with primary ovarian insufficiency and early menopause. Fertility and Sterility. 2016 Dec;106(7):1588–1599.

[2] Peyrallo CV. Falla ovárica prematura. Causa o consecuencia. Revista de la Sociedad Argentina de Endocrinología Ginecológica y Reproductiva. 2015;12:12.

[3] Panay N, Anderson RA, Nappi RE, Vincent AJ, Vujovic S, Webber L, Panay N. REVISION Insuficiencia ovárica prematura: Documento Estratégico de la Sociedad Internacional de. 2020;54.

[4] Sanchez Gonzalez C, Martinez Cruz N, Campos Caña J. Clinical-biochemical characteristics of the primary ovarian failure. An institutional experience of 12 years. Revista de Ginecología y Obstetricia de México. 2017;85:799–808.

[5] Bompoula MS, Valsamakis G, Neofytou S, Messaropoulos P, Salakos N, Mastorakos G, et al. Demographic, clinical and hormonal characteristics of patients with premature ovarian insufficiency and those of early menopause: Data from two tertiary premature ovarian insufficiency centers in Greece. Gynecological Endocrinology. 2020 Aug;36(8):693–697.

[6] Giri R, Vincent AJ. Prevalence and risk factors of premature ovarian insufficiency/early menopause. Seminars in Reproductive Medicine. 2020 Sep;38(4-05):237–246.

[7] Mishra GD, Chung HF, Cano A, Chedraui P, Goulis DG, Lopes P, et al. EMAS position statement: predictors of premature and early natural menopause. Maturitas. 2019 May;123:82–88.

[8] Maclaran K, Panay N. Current concepts in premature ovarian insufficiency. Womens Health (London, England). 2015 Mar;11(2):169–182.

[9] Gomez Tabares GG, Saldarriaga W, Hurtado L. Insuficiencia ovárica prematura. 2018. 24:11

[10] Chon SJ, Umair Z, Yoon MS. Premature ovarian insufficiency: Past, present, and future. Frontiers in Cell and Developmental Biology. 2021 May;9:672890.

[11] Maclaran K, Nikolaou D. Early ovarian ageing. Journal of Obstetrics and Gynaecology Research. 2019;21(2):107–116.

[12] Tsiligiannis S, Panay N, Stevenson JC. Premature ovarian insufficiency and long-term health consequences. Current Vascular Pharmacology. 2019;17(6):604–609.

[13] Lobo Rogiero A. Menopausia y Senectud. Medellín, Colombia: Endocrinol. Reprod. Yen Jaffe Fisiol. Fisiopatol. Manejo Clínico, Octava. AMOLCA; 2019: 323–324.

[14] Torella M, Riemma G, De Franciscis P, La Verde M, Colacurci N. Serum anti-Müllerian hormone levels and risk of premature ovarian insufficiency in female childhood cancer survivors: Systematic review and network meta-analysis. Cancers (Basel). 2021 Dec;13(24):6331.

[15] Louwers YV, Visser JA. Shared genetics between age at menopause, early menopause, POI and other traits. Frontiers in Genetics. 2021 Sep;12:676546.

[16] Mishra GD, Pandeya N, Dobson AJ, Chung HF, Anderson D, Kuh D, et al. Early menarche, nulliparity and the risk for premature and early natural menopause. Human Reproduction. 2017 Mar;32(3):679–686.

[17] Bae J, Park S, Kwon JW. Factors associated with menstrual cycle irregularity and menopause. BMC Womens Health. 2018 Feb;18(1):36.

[18] de Kat AC, Broekmans FJ, Lambalk CB. Role of AMH in prediction of menopause. Front Endocrinology (Lausanne). 2021 Sep;12:733731.

[19] Kim JM, Yang YS, Lee SH, Jee SH. Association between early menopause, gynecological cancer, and tobacco smoking: A cross-sectional study. Asian Pacific Journal of Cancer Prevention. 2021 Oct;22(10):3165–170.

[20] Taylor H, Lubna P, Emre S. Speroff. Endocrinologia ginecológica clínica y esterilidad, 9 edición. Philadelphia: Wolters Kluwer; 2020.

[21] Schipper I, Louwers YV. Premature and early menopause in relation to cardiovascular disease. Seminars in Reproductive Medicine. 2020 Sep;38(4-05):270–276.

[22] Armeni E, Paschou SA, Goulis DG, Lambrinoudaki I. Hormone therapy regimens for managing the menopause and premature ovarian insufficiency. Best Practice & Research Clinical Endocrinology & Metabolism. 2021 Dec;35(6):101561.

[23] Maki PM, Thurston RC. Menopause and brain health: Hormonal changes are only part of the story. Frontiers in Neurology. 2020 Sep;11:562275.

[24] Benvegnu C, Paz V, Singh L, et al. Insuficiencia ovárica prematura. Revista Argentina de Endocrinología y Metabolismo. 2019;56:20–29.

[25] Moukhah S, Ghorbani B, Behboodi-Moghadam Z, Zafardoust S. Perceptions and experiences of women with premature ovarian insufficiency about sexual health and reproductive health. BMC Womens Health. 2021 Feb;21(1):54.

[26] Pinkerton JoAnn V. Fallo ovárico primario - Ginecología y obstetricia. In: Man. MSD Versión Para Prof. 2020. https://www.msdmanuals.com/esec/ professional/ginecolog%C3%ADa-y-obstetricia/anomal%C3%ADasmenstruales/ fallo-ov%C3%A1rico-primario. Accessed 5 Aug 2021

[27] Barriga PP, Montiel GC, Barriga PP, Montiel GC. Insuficiencia Ovárica Primaria en Adolescentes: revisión de la literatura a propósito de un caso clínico. Revista chilena de obstetricia y ginecología. 2021;86(2):217–227.

[28] Maciejewska-Jeske M, Szeliga A, Męczekalski B. Consequences of premature ovarian insufficiency on women’s sexual health. Przegla￿d Menopauzalny. 2018 Sep;17(3):127–130.

[29] Webber L, Anderson RA, Davies M, Janse F, Vermeulen N. HRT for women with premature ovarian insufficiency: A comprehensive review. Human Reproduction Open. 2017 Jul;2017(2):hox007. https://doi.org/10.1093/hropen/hox007.

[30] Llahana S, Follin C, Yedinak C, Grossman A. Advanced practice in endocrinology nursing. Springer; 2019. https://doi.org/10.1007/978-3-319-99817-6