title: Bone density changes in premature ovarian insufficiency patients who have had term pregnancies.
abstract: Premature ovarian insufficiency affects 1% of women under the age of 40 and is associated with a hypoestrogenic state, potentially leading to multiple comorbidities including reduced bone density and fertility. An unpredictable ovarian function is observed in 50% of patients with 5-10% being able to achieve a pregnancy. Longitudinal studies have shown a temporary decline in bone mineral density of up to 5% during pregnancy and lactation in healthy women, with the loss of bone density post-partum being proportional to the period of breastfeeding. Effects of pregnancy in women with premature ovarian insufficiency have not been widely documented. Nevertheless, a lower bone mineral density baseline has been observed pre-conceptually, associated with both the hypoestrogenic state of the condition and the possibility that premature ovarian insufficiency was developed prior to achieving peak bone mass. This may suggest that breastfeeding could cause further deterioration in bone mineral density that may not be easy to recover from due to the reduced baseline levels.
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK mariana.velasco@doctors.org.uk.
authors.forename: Mariana
authors.initials: M
authors.lastname: Velasco
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Debra
authors.initials: D
authors.lastname: Holloway
authors.affiliation: King's College London, London, UK.
authors.forename: Janice
authors.initials: J
authors.lastname: Rymer
mesh_terms: D000328:Adult; D015519:Bone Density / Q000502:physiology*; D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000502:physiology*; D016649:Primary Ovarian Insufficiency / Q000503:physiopathology*
keywords: Bone; ovarian insufficiency; pregnancy; premature ovarian insufficiency; women’s health