Premature ovarian failure. Clinical evaluation of 32 cases

Premature menopause, also termed premature ovarian failure (POF), is characterized by cessation of menstruation before the age of 40 years. Pathogenetic mechanisms are not so clear, particularly genetic implications of cellular apoptosis. Diagnostic approach is multifactorial and therapy depends on the pregnancy wish.

Eight hundred and thirty patients approached the Menopausal Center of the University Department of Gynaecological, Obstetrical and Reproductive Sciences of the Second University of Naples between October 1998 and October 2002. All patients were clinically investigated and selected on the basis of menopausal age, pregnancy wish and menopausal syndrome.

Menopausal mean age was 48.31+/-4.62 years and 32 patients (4%) were affected by premature ovarian failure because of menopausal appearance before the age of 40. Three of these patients were treated to have a pregnancy; the remaining 29 required medical treatment to reduce menopausal symptoms. The osteoporosis risk for premature menopause patients was similar to the other women. The cardiovascular risk was increased because of an increase in risk factors in premature ovarian failure patients. No breast or endometrial pathology was revealed and therapy compliance was satisfactory without any drop-out.

Premature ovarian failure has a varied etiology, pathogenetic aspects, clinical evolution and therapeutical approach. Adequate treatment of premature menopause women presents good compliance, resolution of infertility when required and a successful resolution of menopausal symptoms.