Bone Loss in Young Women With Karyotypically Normal Spontaneous Premature Ovarian Failure

Abstract

Two-thirds of young women with karyotypically normal spontaneous premature ovarian failure have a femoral neck bone mineral density more than 1 SD below the mean of a reference group. These young women need early education regarding strategies to maintain their bone mass and ongoing medical evaluation to maintain compliance with these strategies.

Clinical guidelines for gynecologic care after hematopoietic SCT. Report from the international consensus project on clinical practice in chronic GVHD

“…49 POF is associated with symptoms of estrogen deficiency, such as hot flushes, night sweats, mood disorders, sleep disorders, lack of concentration, arthralgia, impaired sexual function 50 and loss of reproductive potential, all of which negatively impact quality of life. 51,52 Lack of estrogen at an early age prevents the development of secondary sex characteristics, increases the risk for osteoporosis, 53 cognitive impairment 54 and cardiovascular disease [55][56][57][58] that are frequently observed in women after HSCT. 59,60 However, attributing these diseases to POF is difficult because their occurrence are influenced by other factors, such as the use of steroids, calcineurin inhibitors, selective serotonin receptor inhibitors and proton pump inhibitors, hyperlipidemia or vitamin D deficiency.…”

Primary Ovarian Failure in a Teenager-A case report

“…It is important to initiate the hormonal replacement therapy after the diagnosis of POF, as untreated patients are at a great risk of bone loss due to increased osteoclast activities, resulting in osteopenia as well as osteoporosis. 7 Furthermore, most of the patients develop symptoms of estrogen deficiency, including vasomotor flushes and vaginal dryness, both of IJBR (2013) 04 (05) www.ssjournals.com which respond to estrogen therapy effectively. Most women with primary ovarian failure opt for long term oestrogen replacement therapy in order to prevent symptoms of oestrogen deficiency and osteoporosis.…”

Pharmacology of Hormone Replacement Therapy in Menopause

“…Moreover, the impaired endothelial function found in women with POI, precursor of more severe vascular abnormalities, was improved by hormonal replacement, further supporting the role of steroids in normal cardiovascular function (Kalantaridou et al, 2004). POI patients present with low BMD, which seems to be greatly influenced by the accelerated bone loss during the first 4-5 years of menopause (Amarante et al, 2011;Anasti et al, 1998;Gallagher, 2007;Uygur et al, 2005;van Der Voort et al, 2003), and hence having an increased risk of fractures compared to their peers who underwent a physiological menopause. Finally, an increased risk for cognitive impairment, dementia and Parkinson disease, inversely proportional with age at menopause, was reported in premature menopausal women following oophorectomy (Rocca et al, 2007(Rocca et al, , 2008.…”