title: Sex hormone replacement in ovarian failure - new treatment concepts.
abstract: Premature ovarian failure is associated with decreased bone mass and fractures, and an increased risk of premature death from cardiovascular disease. There is also fertility compromise associated not only with the loss of ovarian function but, in those with pre-pubertal POF, inadequate uterine morphology. A wide variety of hormone replacement regimes are reported, but there is no clear evidence of best practice. Hormone replacement therapy (HRT) and the combined oral contraceptive pill (COCP) will suppress menopausal symptoms; however neither is designed to achieve physiological replacement of oestrogen and progesterone. There is evidence that physiological sex steroid replacement is superior to standard hormone replacement, in improving uterine volume as well as an improved blood pressure profile and bone mineral density. Sex steroid replacement therapy is long-term in these women, and therefore it is essential that the risk benefit ratio is optimal to maximise longer term health.
authors.affiliation: Obstetrics and Gynaecology, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, G31 2ER, United Kingdom. Electronic address: jenifer.sassarini@glasgow.ac.uk.
authors.forename: Jenifer
authors.initials: J
authors.lastname: Sassarini
authors.affiliation: Obstetrics and Gynaecology, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, G31 2ER, United Kingdom. Electronic address: maryann.lumsden@glasgow.ac.uk.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Lumsden
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom. Electronic address: hilary.critchley@ed.ac.uk.
authors.forename: Hilary O D
authors.initials: HO
authors.lastname: Critchley
mesh_terms: D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D016649:Primary Ovarian Insufficiency / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D003277:Contraceptives, Oral, Combined; D012739:Gonadal Steroid Hormones
keywords: bone; breast; cardiovascular; physiological sex steroid replacement; premature ovarian failure; uterine morphology