title: Poor Compliance to Hormone Therapy and Decreased Bone Mineral Density in Women with Premature Ovarian Insufficiency.
abstract: Premature ovarian insufficiency leads to through infertility and estrogen deficiency. Optimal management encompasses estrogen replacement therapy. Long-term outcome of women with POI is not known. We design a study to evaluate the medical care, hormone replacement therapy compliance and bone mineral density (BMD) in POI women with at least a five-year follow-up after the first evaluation. One hundred and sixty-two patients (37.3±8.0 years) were evaluated (follow-up 7.9±2.8 years). Sixty-nine patients (42.6%) had stopped their hormone replacement therapy (HRT) for at least one year during the follow up period. BMD determination at initial evaluation and at follow-up visit was completed in 92 patients. At first evaluation, 28 patients (30%) had osteopenia and 7 (8%) had osteoporosis. At follow up, 31 women (34%) had BMD impairment with osteopenia in 61% and osteoporosis in 5%. In univariate analysis and multivariate analysis, there was a significant loss of femoral BMD in women who had stopped their HRT for over a year. In conclusion, this first study concerning long-term follow-up of POI patients shows the poor compliance to their HRT, despite its importance in the prevention of bone demineralization. This study reinforces the need for follow up and specific care for POI women.
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, Paris, France.|Université Pierre et Marie Curie, Univ Paris, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bachelot
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, Paris, France.|Université Pierre et Marie Curie, Univ Paris, Paris, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Nicolas
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, Paris, France.
authors.forename: Solenne
authors.initials: S
authors.lastname: Gricourt
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dulon
authors.affiliation: AP-HP, Hôpital Pitié-Salpêtrière, Department of Hormonal Biochemistry, Paris, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Leban
authors.affiliation: AP-HP, Hôpital Pitié-Salpêtrière, Clinical Research Unit, Paris, France.|Université Pierre et Marie Curie, Univ Paris, Paris, France.
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Golmard
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, Paris, France.|Université Pierre et Marie Curie, Univ Paris, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Touraine
mesh_terms: D000328:Adult; D015519:Bone Density / Q000187:drug effects; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008594:Menopause, Premature / Q000187:drug effects; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016649:Primary Ovarian Insufficiency / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014424:Turner Syndrome / Q000188:drug therapy / Q000473:pathology