Premature Ovarian Insufficiency: A Review

Abstract

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.

Characteristics of the vaginal microbiome in women with premature ovarian insufficiency

“…Clinically, the condition is characterised by a continuous decline in ovarian function, resulting in earlier cessation of menstruation than normal [2]. Women with POI can also experience comorbidities, including a low chance of natural conception [3], urogenital atrophy [4], decreased bone mineral density [5], increased risk of autoimmune and thyroid disease [6], cognitive dysfunction [7], shortened life expectancy [8], and cardiovascular disease [9].…”

“…The cause of POI is currently unknown; however, a number of potential triggers are associated with the development of the disease, including genetic defects, autoimmune dysfunction, enzyme deficiency, surgical intervention, chemotherapy, radiotherapy, and environmental factors [7,10]. Several studies have indicated that bacterial vaginosis is associated with infertility [11].…”