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Bone loss in young women with karyotypically normal spontaneous premature ovarian failure
J N Anasti1, S N Kalantaridou, L M Kimzey
1Section on Women's Health, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center Nursing Department, National Institutes of Health, Bethesda, Maryland 20892-1862, USA.
Objective:
To evaluate the effects of karotypically normal spontaneous premature ovarian failure on femoral neck bone mineral density.
Methods:
Eighty-nine women with karyotypically normal spontaneous premature ovarian failure who desired fertility were evaluated at a tertiary care academic center and underwent hip and spinal bone density measurements by conventional dual-photon absorptiometry. Seventy-seven of the women (87%) had sought medical advice previously and had taken a variety of estrogen and progestin replacement regimens at least intermittently. The median (range) age was 32 (20-39) years, and the median (range) time since diagnosis was 1.5 (0.5-11) years. Findings were compared with a reference group of 218 regularly menstruating women of similar age.
Results:
Sixty of the 89 women with premature ovarian failure (67%, 95% confidence interval 57, 77) had a femoral neck bone mineral density more than 1 standard deviation (SD) below the mean of the reference group (P < .001, chi2 with Yates correction). Even in women in whom the bone mineral density measurement was made within just 1.5 years of the diagnosis, nearly one-half (47%) had a femoral neck bone mineral density more than 1 SD below the mean of the reference group (P < .01).
Conclusion:
Two-thirds of young women with karyotypically normal spontaneous premature ovarian failure have a femoral neck bone mineral density more than 1 SD below the mean of a reference group. These young women need early education regarding strategies to maintain their bone mass and ongoing medical evaluation to maintain compliance with these strategies.