Premature Ovarian Failure

Premature ovarian failure (POF) is an ovarian disorder of diverse etiologies characterized by amenorrhea, elevated serum gonadotropins, and hypoestrogenemia in women less than 40 years of age. This chapter reviews several questions regarding the cause, treatment approaches, fertility issues, and follow up details with respect to the ideal management of POF. This review can help the clinicians make progress towards a better understanding of the causes of premature ovarian failure. The diagnosis of POF always comes as a shock to the patient, so it is important for clinician to discuss with the patient the issues set forth. A number of women are found with X-chromosome anomaly. Another cause of ovarian failure is usually autoimmune. Thorough evaluation and screening of X chromosome and related autoimmune conditions is important at the initial diagnosis. It is however difficult to assure the potential for fertility as no specific treatment has been proven beneficial. Long term follow-up generally addresses the risks of hypoestrogenism such as osteoporosis and increased risk of heart disease. For optimal management of patient with POF condition, it is important for clinician to spend time to evaluate and counsel the patient with appropriate health maintenance follow-up.