Premature ovarian insufficiency: the context of long-term effects.
OBJECTIVE
Premature ovarian insufficiency (POI) is defined as the cessation of the ovarian function before the age of 40 years. POI aetiology may be related to iatrogenic or endogenous factors and in many cases remains unclear. The aim of this review was to characterize the long-term consequences of POI.


METHODS
The available literature regarding the long-term consequences of POI from MEDLINE has been reviewed.


RESULTS
Lack of ovarian steroids synthesis has serious consequences for women's health. The short-term effects are similar to spontaneous menopause and refer mainly to the climacteric syndrome. In a longer perspective, POI affects a variety of aspects. It obviously and drastically reduces the chances for spontaneous pregnancies. Oestrogen loss leads also to urogenital atrophy. The most common urogenital symptoms include vaginal dryness, vaginal irritation and itching. The urogenital atrophy and hypoestrogenism interferes also with sexual functioning. Patients with POI are threatened by a decrease in bone mineral density (BMD). POI women also experience psychological distress and some studies have shown an increased risk of neurodegenerating diseases. Overall, POI women have a shortened life expectancy, mainly due to cardiovascular disease. Some studies have reported a reduced risk of breast cancer in this group of patients.


CONCLUSIONS
In conclusion there are several well-characterized health risks in POI women. With every patient, an individualized approach is required to properly recognize and prevent these risks.
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland.
A
A
Podfigurna-Stopa
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland.
A
A
Czyzyk
Department of Gynecological Endocrinology, Warsaw Medical University, Warsaw, Poland.
M
M
Grymowicz
Department of Gynecological Endocrinology, Warsaw Medical University, Warsaw, Poland.
R
R
Smolarczyk
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland.
K
K
Katulski
II Department of Obstetrics and Gynaecology, Warsaw Medical University, Warsaw, Poland.
K
K
Czajkowski
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland. blazejmeczekalski@yahoo.com.
B
B
Meczekalski
D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D016649:Primary Ovarian Insufficiency / Q000209:etiology* / Q000517:prevention & control*; D013995:Time
Bone mineral density; Cardiovascular disease; Fertility; Hypoestrogenism; Premature ovarian insufficiency; Sexual dysfunction