title: The silent grief: psychosocial aspects of premature ovarian failure.
abstract: OBJECTIVE
  Premature ovarian failure in women under 40 years is uncommon, but not rare (1-3%), with up to 2.5% of adolescents affected. This study aims to investigate women's experiences of diagnosis, perception of cause, treatment, main concerns, long-term consequences and impact on self-esteem, sexual functioning and health-related quality of life.
  
  
  METHODS
  This was a cross-sectional study, using a single-group design, including quantitative and qualitative measures. Two hundred and twenty questionnaires were sent to women recruited from the databases of two London specialist multidisciplinary clinics and from a national premature menopause self-help website. The questionnaire included the Rosenberg's Self Esteem Questionnaire, SF 36 Health Survey (quality of life), the Sexual Personal Experiences Questionnaire and the Young Menopause Assessment questionnaire, following a pilot to assess acceptability and feasibility.
  
  
  RESULTS
  The response rate was 62% in women aged 19-61 years. The majority of women felt that they had been offered inadequate information; 53% did not know the reason for their condition, 30% obtained a diagnosis within 6 months, and the diagnosis for 22% took up to 3 years. Fertility and bone health were main concerns, followed by emotional well-being. Libido and vaginal dryness were perceived as the main long-term effects by 79% of the women. The internet was the main source of information. The majority requested more information targeted to their age group and 49% requested psychological support, citing a negative impact on their self-esteem.
  
  
  CONCLUSIONS
  This study examined women's perceptions of premature ovarian failure, its impact and the services they received. The results can be used to inform service reconfiguration and improvement.
authors.affiliation: Menopause Clinic & Research Unit, Northwick Park Hospital, Level 5, Watford Road, Harrow, Middlesex HA1 3UJ, UK.
authors.forename: D
authors.initials: D
authors.lastname: Singer
authors.forename: E
authors.initials: E
authors.lastname: Mann
authors.forename: M S
authors.initials: MS
authors.lastname: Hunter
authors.forename: J
authors.initials: J
authors.lastname: Pitkin
authors.forename: N
authors.initials: N
authors.lastname: Panay
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006117:Grief; D006801:Humans; D008594:Menopause, Premature / Q000523:psychology; D008875:Middle Aged; D017060:Patient Satisfaction; D010465:Perception; D016649:Primary Ovarian Insufficiency / Q000150:complications / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D012649:Self Concept; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D014623:Vaginal Diseases / Q000453:epidemiology / Q000209:etiology