What is the Best Management Strategy for a 20-year-old Woman With Premature Ovarian Failure?

Long-term Health Effects

The long-term health effects of oestrogen deficiency must be discussed in a sensitive manner, recognizing that information may need to be repeated at subsequent visits. Written information and directions to reliable internet resources may be welcomed.

Early menopause is associated with decreased breast cancer risk,^[20] lower bone density and increased fracture risk,^[21–24] increased cardiovascular disease^[25] and decreased life expectancy.^[26] Published data on health risks derive largely from cohort studies of women with surgical menopause (bilateral oophorectomy). There is a lack of studies assessing long-term outcomes in spontaneous POF; oestrogen deficiency is less extreme than surgical menopause, so the health effects may not be as great, and it is difficult to counsel women on their degree of risk or on how much the risk is ameliorated by hormone therapy. The FRAX scoring system that assesses the risk of osteoporotic fracture cannot be used in young women.^[27]

Clin Endocrinol. 2012;77(2):182-186. © 2012 Blackwell Publishing