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30 - Premature ovarian failure and ovarian ageing

from Part III - Management of specific disorders

Published online by Cambridge University Press:  04 May 2010

By
Colin J. Davis  and
Gerard S. Conway
Edited by
Adam H. Balen ,
Sarah M. Creighton ,
Melanie C. Davies ,
Jane MacDougall  and
Richard Stanhope
Colin J. Davis
Affiliation:
St Bartholomews and the Royal London Hospitals, London, UK
Gerard S. Conway
Affiliation:
University College Hospital and The Middlesex Hospital, London, UK
Adam H. Balen
Affiliation:
Leeds Teaching Hospitals, University Trust
Sarah M. Creighton
Affiliation:
University College London Hospitals
Melanie C. Davies
Affiliation:
University College London
Jane MacDougall
Affiliation:
Addenbrooke's Hospital, Cambridge
Richard Stanhope
Affiliation:
Great Ormond Street Hospital
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Summary

Introduction

The ovary is a particularly unusual organ in that it is programmed to expire long before the average age of death. As such, it provides a unique model of the ageing process. An ovary that fails prematurely might do so through some defect in its development or through accelerated ageing. Because it is difficult to distinguish between these possibilities, it is convenient to consider processes of dysgenesis and demise together. Various labels have been applied to the phenomenon of early failure of the ovary: ovarian dysgenesis is usually applied to those women who present with primary amenorrhoea; premature ovarian failure (POF) applies to those with secondary hypergonadotrophic amenorrhoea before the age of 40; and early ovarian failure applies to those who enter the menopause between the ages of 40 and 45. Resistant ovary syndrome and occult ovarian failure are hypergonadotrophic states without amenorrhoea but are usually considered to be part of this spectrum of disorders. POF has a prevalence of 1% and is defined as amenorrhoea of greater than six months' duration in the presence of raised gonadotrophins, follicle-stimulating hormone (FSH) greater than 40 IU/l, on at least two occasions and occurring before the age of 40 (Coulam et al., 1986). This contrasts with the mean age of menopause at 51 years (McKinlay et al., 1972).

Aetiology

The cause of POF in most instances is unclear; however two broad mechanisms can be considered, acquired or genetic aetiologies.

Type
Chapter
Information
Paediatric and Adolescent Gynaecology
A Multidisciplinary Approach
 , pp. 373 - 388
Publisher: Cambridge University Press
Print publication year: 2004

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