scholarly journals Premature Ovarian Insufficiency - an update on recent advances in understanding and management

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2069 ◽  
Author(s):  
Saioa Torrealday ◽  
Pinar Kodaman ◽  
Lubna Pal
Keyword(s):  
Ovarian Function ◽  
Clinical Medicine ◽  
Premature Ovarian Insufficiency ◽  
Clear Understanding ◽  
Timely Manner ◽  
Ovarian Insufficiency ◽  
Ongoing Research ◽  
Health Complications

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.

scholarly journals Premature Ovarian Insufficiency: A Review

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.

scholarly journals Long-term outcome of ovarian function in women with intermittent premature ovarian insufficiency

2016 ◽  
Vol 86 (2) ◽  
pp. 223-228 ◽  
Author(s):  
Anne Bachelot ◽  
Carole Nicolas ◽  
Maud Bidet ◽  
Jérôme Dulon ◽  
Monique Leban ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Term Outcome ◽  
Long Term Outcome

Premature ovarian insufficiency: Genetic causes and treatment options. A literature review

2021 ◽  
Vol 70 (3) ◽  
pp. 75-91
Author(s):  
Valentina M. Denisova ◽  
Maria I. Yarmolinskaya ◽  
Karina A. Zakurayeva
Keyword(s):  
Literature Review ◽  
Ovarian Function ◽  
Treatment Options ◽  
Clinical Signs ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Diagnostic Features ◽  
Genetic Causes ◽  
Pubmed Database

Premature ovarian insufficiency is a syndrome characterized by hypergonadotropic ovarian insufficiency and the reduction of ovarian function before age 40. This leads to reproductive failures, metabolic changes, and a decrease in quality of life. Currently, occult and initial forms of premature ovarian insufficiency, which have their own diagnostic features and management tactics, can be figured out. The frequency of this syndrome is between 1.1 and 3.7% and the tendency for incidence to increase can be seen. This article is a literature review of the data available in the PubMed database (20052020), with international clinical guidelines taken into consideration. The genetic causes of premature ovarian insufficiency, clinical signs of this pathology and treatments options for such patients are included into the review. In addition, some features of assisted reproductive technology within this group are described.

scholarly journals How to Protect Ovarian Function before and during Chemotherapy?

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.

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

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.

Premature Ovarian Insufficiency and Long-Term Health Consequences

2019 ◽  
Vol 17 (6) ◽  
pp. 604-609 ◽  
Author(s):  
Sophia Tsiligiannis ◽  
Nick Panay ◽  
John C. Stevenson
Keyword(s):  
Ovarian Function ◽  
Management Strategies ◽  
Premature Ovarian Insufficiency ◽  
Health Consequences ◽  
Mineral Density ◽  
Ovarian Insufficiency ◽  
Oestrogen Deficiency ◽  
The Subject ◽  
Neurological Effects

Premature ovarian insufficiency (POI) is defined as the cessation of ovarian function before the age of 40 years. The trio of amenorrhea, elevated gonadotropins and oestrogen deficiency is associated with long-term health consequences including increased cardiovascular disease (CVD), decreased bone mineral density (BMD), significantly reduced fertility, psychological distress, vulvovaginal atrophy, neurological effects and overall reduced life expectancy. There are deficits in our understanding of this condition and subsequently the long-term health consequences. The underlying aetiology of POI and the optimal management strategies are also poorly understood. Our knowledge of long-term cardiovascular consequences specifically relating to women with POI is limited as most data on the subject are derived from studies involving women who experienced menopause at the natural age (after 40 years with an average age of 51).

Managing common problems in the menopause

2018 ◽  
Vol 11 (7) ◽  
pp. 378-386
Author(s):  
Louise Newson ◽  
Nick Panay
Keyword(s):  
Quality Of Life ◽  
Health Risks ◽  
Healthcare Professionals ◽  
Medical Condition ◽  
Hormone Replacement ◽  
Ovarian Insufficiency ◽  
Life Event ◽  
Common Problems

The menopause is a normal life event for women and not an illness or medical condition. Despite this, menopause can predispose vulnerable women to distressing symptoms that impact adversely on their quality of life and to long term medical conditions such as osteoporosis, cardiovascular disease and dementia. Many healthcare professionals are uncertain about the management of the menopause, and this leads to many women not receiving treatment which is often beneficial to them. This article will cover the diagnosis of the menopause including premature ovarian insufficiency. Some of the health risks of the menopause will be discussed and treatment of the menopause, with a particular focus on hormone replacement therapy, will be covered in detail.

scholarly journals Efficacy of Traditional Chinese Medicine Tonifying Kidney (Bushen) and Activating Blood (Huoxue) Prescription for Premature Ovarian Insufficiency: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Hui-Fang Li ◽  
Qi-Hong Shen ◽  
Wen-Jun Chen ◽  
Wei-Min Chen ◽  
Zhang-Feng Feng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Peak Systolic Velocity ◽  
Premature Ovarian Insufficiency ◽  
Cochrane Library ◽  
Ovarian Insufficiency

Context. Premature ovarian insufficiency (POI) is one of the difficult gynecological diseases with complex etiologies. Tonifying kidney (bushen) and activating blood (huoxue) prescription (TKABP) is a popular traditional Chinese medicine (TCM) therapy which is commonly applied for POI. However, its efficacy and safety are still controversial. Objective. We carried out this systematic review and meta-analysis to evaluate the effectiveness of TKABP on POI. Methods. The following eight databases were searched from the establishment to September 30, 2019, for randomized controlled trials (RCTs): PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese BioMedical database (CBM), Chinese Scientific Journal Database (VIP), and the Wanfang database. The quality of evidence was estimated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results. Twenty-three RCTs involving 1712 patients with POI were included. Compared to hormone therapy (HT) groups, TKABP groups showed a significantly higher total effective rate (RR: 1.10; 95% CI: 1.04–1.17; P<0.01, I2 = 32%). In addition, TKABP groups revealed a better improvement in terms of serum follicle-stimulating hormone (FSH) levels, serum estradiol (E2) levels, peak systolic velocity (PSV) of ovarian stromal blood, and Kupperman index (KI) score. However, serum luteinizing hormone (LH) levels and ovarian volume (OV) showed no significant statistical difference. Subgroup analyses showed that herbal paste and 3 months of treatment duration had a greater effect on the improvement of hormone levels. Besides, the occurrence of related adverse events in TKABP groups was lower than that in HT groups. Conclusions. Our review suggests that TKABP appears to be an effective and safe measure for patients with POI, and the herbal paste may be superior. However, the methodological quality of included RCTs was unsatisfactory, and it is necessary to verify its effectiveness with furthermore standardized researches of rigorous design.

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