Premature ovarian insufficiency: hormonal aspects and long-term health

Premature ovarian insufficiency is a complex and relatively poorly understood entity with a myriad of etiologies and multisystem sequelae that stem from premature deprivation of ovarian sex hormones. Timely diagnosis with a clear understanding of the various comorbidities that can arise from estrogen deficiency is vital to appropriately counsel and treat these patients. Prompt initiation of hormone therapy is critical to control the unsolicited menopausal symptoms that many women experience and to prevent long-term health complications. Despite ongoing efforts at improving our understanding of the mechanisms involved, any advancement in the field in recent decades has been modest at best and researchers remain thwarted by the complexity and heterogeneity of the underpinnings of this entity. In contrast, the practice of clinical medicine has made meaningful strides in providing assurance to the women with premature ovarian insufficiency that their quality of life as well as long-term health can be optimized through timely intervention. Ongoing research is clearly needed to allow pre-emptive identification of the at-risk population and to identify mechanisms that if addressed in a timely manner, can prolong ovarian function and physiology.

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Cardiovascular health in patients with premature ovarian insufficiency. Management of long-term consequences

Menopausal Review ◽

10.5114/pm.2018.78551 ◽

2018 ◽

Vol 17 (3) ◽

pp. 109-111 ◽

Cited By ~ 1

Author(s):

Agnieszka Podfigurna ◽

Błażej Męczekalski

Keyword(s):

Cardiovascular Health ◽

Premature Ovarian Insufficiency ◽

Ovarian Insufficiency ◽

Long Term Consequences

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Premature ovarian insufficiency – hormone replacement therapy and management of long-term consequences

Menopausal Review ◽

10.5114/pm.2018.78559 ◽

2018 ◽

Vol 17 (3) ◽

pp. 135-138 ◽

Cited By ~ 4

Author(s):

Paulina Machura ◽

Monika Grymowicz ◽

Ewa Rudnicka ◽

Wojciech Pięta ◽

Anna Calik-Ksepka ◽

...

Keyword(s):

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Hormone Replacement ◽

Premature Ovarian Insufficiency ◽

Ovarian Insufficiency ◽

Long Term Consequences

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How to Protect Ovarian Function before and during Chemotherapy?

Journal of Clinical Medicine ◽

10.3390/jcm10184192 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4192

Author(s):

Luca Arecco ◽

Tommaso Ruelle ◽

Valentino Martelli ◽

Andrea Boutros ◽

Maria Maddalena Latocca ◽

...

Keyword(s):

Ovarian Function ◽

Premenopausal Women ◽

Protective Role ◽

Premature Ovarian Insufficiency ◽

Negative Consequences ◽

Key Factors ◽

Ovarian Insufficiency ◽

Natural Menopause ◽

Premenopausal Patients

A significant number of women receive a cancer diagnosis before their age of natural menopause. Among these patients, the most frequent neoplasms are breast cancer, gynecological, and hematological malignancies. Premature ovarian insufficiency and infertility are among the most feared short- to long-term consequences of anticancer treatments in premenopausal patients. Both patient- and treatment-related characteristics are key factors in influencing the risk of gonadotoxicity with the use of chemotherapy. The cryopreservation of oocytes/embryos is a standard strategy for fertility preservations offered to young women interested in future family planning, but it does not allow gonadal function protection during chemotherapy. Ovarian suppression with gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy is now recommended as an option to reduce the risk of gonadotoxicity in order to avoid the negative consequences of premature ovarian insufficiency in premenopausal women receiving cytotoxic therapy, including those not interested in fertility preservation. This review summarizes the risk of treatment-induced gonadotoxicity in premenopausal patients and the evidence available on the protective role of administering GnRHa during chemotherapy to preserve ovarian function.

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The Role of Noncoding RNA in the Pathophysiology and Treatment of Premature Ovarian Insufficiency

International Journal of Molecular Sciences ◽

10.3390/ijms22179336 ◽

2021 ◽

Vol 22 (17) ◽

pp. 9336

Author(s):

Katarzyna Pankiewicz ◽

Piotr Laudański ◽

Tadeusz Issat

Keyword(s):

Neurological Disorders ◽

Noncoding Rna ◽

Ovarian Function ◽

Hormone Replacement ◽

Premature Ovarian Insufficiency ◽

Mineral Density ◽

Ovarian Insufficiency ◽

Exosomal Mirnas

Premature ovarian insufficiency (POI) is defined as a loss of ovarian function before the age of 40 years, with a prevalence rate estimated at approximately 1%. It causes infertility and is related to serious long-term health consequences, including reduced life expectancy, increased cardiovascular risk, decreased bone mineral density and neurological disorders. There is currently no effective therapy for POI that is widely available in clinical practice; therefore, the treatment of patients with POI is based on hormone replacement therapy. One of the recent advances in the understanding of the pathophysiology of POI has been the role of microRNAs (miRNAs) and other noncoding RNAs (ncRNAs) in the disease. Moreover, intensive research on human folliculogenesis and reproductive biology has led to the development of novel promising therapeutic strategies with the use of exosomal miRNAs derived from mesenchymal stem cells to restore ovarian function in POI patients. This narrative review focuses on the new studies concerning the role of ncRNAs in the pathogenesis of POI, together with their potential as biomarkers of the disease and targets for therapy.

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Novel guidelines on surveillance for breast cancer, cardiomyopathy, male gonadotoxicity, and premature ovarian insufficiency from the PanCare and International Guideline Harmonization Group on long-term follow-up after cancer in childhood

memo - Magazine of European Medical Oncology ◽

10.1007/s12254-018-0387-z ◽

2018 ◽

Vol 11 (1) ◽

pp. 54-58 ◽

Cited By ~ 1

Author(s):

Edit Bardi ◽

Leo Kager

Keyword(s):

Breast Cancer ◽

Premature Ovarian Insufficiency ◽

International Guideline ◽

Ovarian Insufficiency ◽

Long Term Follow Up ◽

After Cancer

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Premature Ovarian Insufficiency: A Review

EMJ Reproductive Health ◽

10.33590/emjreprohealth/19-00041 ◽

2019 ◽

Author(s):

Avantika Gupta ◽

Purnima Tiwari

Keyword(s):

Ovarian Function ◽

Well Being ◽

Premature Ovarian Insufficiency ◽

Ovarian Insufficiency ◽

Catastrophic Event ◽

Timely Initiation ◽

Population Subgroup ◽

Short And Long Term

Premature ovarian insufficiency is waning of ovarian function before the age of 40 years. This hypoestrogenic state is characterised by menstrual irregularities and loss of fertility in the patient. This review narrates evaluation, consequences, and management of this complex entity. Truncation in ovarian physiology at such an early age renders the patient prone for various short- and long-term health consequences which negatively affect physical and psychological well-being of the patients. Therefore, this review emphasises that timely initiation of hormonal therapy is mandatory to mitigate the distressing menopausal and/or other hypoestrogenic symptoms to improve the quality of life of such patients. Although much has been said about premature ovarian insufficiency, many aspects of this condition still need to be explored in order to identify this population subgroup before happening of the catastrophic event and to formulate strategies and interventions to delay the premature cessation of ovarian functions.

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