The role of hormone replacement therapy in the management of premature ovarian failure

摘要

Premature ovarian failure (POF) is classically defined by amenorrhea of 4-6 months duration, with two follicle-stimulating hormone measurements in the menopausal range (made at an interval of 1-2 months), occurring before 40 years of age. In many cases affected women retain ovarian follicles, and some women have intermittent follicular development, variations in endogenous estradiol levels, and irregular menstrual bleeding. Consequently, many clinicians now believe that 'primary ovarian insufficiency' might be a more accurate term for this condition. The prevalence of POF is 1:1,000 by age 30 years and 1-2:100 by age 40 years. In most cases the karyotype is XX and the etiology remains unknown. The two major effects of POF are hypoestrogenism and infertility. Hormone replacement therapy (HRT) should, therefore, be considered for these patients.