title: Prevalence of premature ovarian failure in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  To estimate the prevalence of premature ovarian failure (POF) and its associated factors in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Cross-sectional study including consecutive SLE women <60 years of age attending a rheumatology clinic. A face-to-face interview was undertaken to obtain demographic, gynaecological and lupus characteristics. Additional rheumatologic and endocrine data were retrieved from patients' medical records. POF prevalence was estimated in the study sample and in a subgroup of patients aged <40 years at interview. Associations between POF and selected variables were assessed by logistic regression analyses.
  
  
  RESULTS
  A total of 961 patients were analysed. Prevalence of POF, secondary amenorrhea of known cause, menopause and hysterectomy were 5.4%, 0.8%, 7.8% and 4.4%, respectively. In 674 (70%) patients who had not been exposed to cyclophosphamide (CYC) the prevalence of POF was 0.6%. Disease activity over time (OR 1.4 (CI 95% 1.0-1.8, p < 0.05)) and CYC treatment (OR 5.9 (CI 95% 1.8-18.8, p < 0.01)) were associated with higher prevalence. Association between POF and endocrine autoimmune diseases was not found.
  
  
  CONCLUSIONS
  In the absence of CYC treatment, the prevalence of POF in lupus patients is consistent with that reported in the general population. The existence of autoimmune processes at the ovary seems unlikely in most lupus patients.
authors.affiliation: Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.
authors.forename: J
authors.initials: J
authors.lastname: Mayorga
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Alpízar-Rodríguez
authors.affiliation: Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.
authors.forename: J
authors.initials: J
authors.lastname: Prieto-Padilla
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.
authors.forename: J
authors.initials: J
authors.lastname: Romero-Díaz
authors.affiliation: Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México mcravioto@prodigy.net.mx.
authors.forename: M C
authors.initials: MC
authors.lastname: Cravioto
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000453:epidemiology*; D008593:Menopause; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010053:Ovary / Q000503:physiopathology*; D015995:Prevalence; D016649:Primary Ovarian Insufficiency / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
keywords: Reproductive; cyclophosphamide treatment; endocrine; epidemiology; hormone; premature gonadal failure; premature ovarian failure; risk factors; systemic lupus erythematosus