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Erschienen in: Journal für Gynäkologische Endokrinologie/Schweiz 2/2018

15.05.2018 | Originalien

Prämature Ovarialinsuffizienz

verfasst von: Dr. Susanna Weidlinger

Erschienen in: Journal für Gynäkologische Endokrinologie/Schweiz | Ausgabe 2/2018

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Zusammenfassung

Der Begriff „prämature Ovarialinsuffizienz“ (POI) bezeichnet den vorzeitigen Verlust der Ovarialfunktion vor dem 40. Lebensjahr mit dem konsekutiven kombinierten Auftreten eines hypergonadotropen Hypogonadismus und einer primären/sekundären Amenorrhoe. Die Diagnostik beinhaltet eine detaillierte Anamnese (Chemotherapie, Radiotherapie, Operationen) sowie die Abklärung genetischer Ursachen und eines polyglandulären Autoimmunsyndroms. Bei Diagnosestellung wird die Durchführung eines DXA-Scans zur Bestimmung der Basisknochendichte empfohlen. Die prämature Ovarialinsuffizienz hat nicht nur einschneidende Auswirkungen auf die Fertilität, sondern geht auch mit negativen Langzeitfolgen u. a. auf die Knochengesundheit, das kardiovaskuläre System und die kognitive Funktion einher. Eine Hormonersatztherapie (HRT) zumindest bis zum durchschnittlichen regelrechten Menopausenalter wird zur Primärprävention östrogenmangelbedingter Langzeitfolgen empfohlen. Die Risiko-Nutzen-Analyse einer HRT, wie wir sie aus Daten von Frauen mit regelrechter Menopause kennen, darf nicht uneingeschränkt auf das Kollektiv der Patientinnen mit POI extrapoliert werden. Bei Patientinnen mit POI wiegt der Nutzen einer HRT deutlich schwerer als die potenziellen Risiken.
Literatur
1.
Zurück zum Zitat Albright F, Smith P, Fraser R (1942) A syndrome characterized by primary ovarian insufficiency and decreased stature. Am J Med Sci 204:625–648 CrossRef Albright F, Smith P, Fraser R (1942) A syndrome characterized by primary ovarian insufficiency and decreased stature. Am J Med Sci 204:625–648 CrossRef
2.
Zurück zum Zitat European Society for Human Reproduction and Embryology (2016) ESHRE guideline: management of women with premature ovarian insufficiency. Hum Reprod 31(5):926–937 CrossRef European Society for Human Reproduction and Embryology (2016) ESHRE guideline: management of women with premature ovarian insufficiency. Hum Reprod 31(5):926–937 CrossRef
4.
Zurück zum Zitat Jiao X et al (2012) Cytogenetic analysis of 531 Chinese women with premature ovarian failure. Hum Reprod 27(7):2201–2207 CrossRefPubMed Jiao X et al (2012) Cytogenetic analysis of 531 Chinese women with premature ovarian failure. Hum Reprod 27(7):2201–2207 CrossRefPubMed
5.
Zurück zum Zitat Kalantari H et al (2013) Cytogenetic analysis of 179 Iranian women with premature ovarian failure. Gynecol Endocrinol 29(6):588–591 CrossRefPubMed Kalantari H et al (2013) Cytogenetic analysis of 179 Iranian women with premature ovarian failure. Gynecol Endocrinol 29(6):588–591 CrossRefPubMed
6.
7.
Zurück zum Zitat Wittenberger MD et al (2007) The FMR1 premutation and reproduction. Fertil Steril 87(3):456–465 CrossRefPubMed Wittenberger MD et al (2007) The FMR1 premutation and reproduction. Fertil Steril 87(3):456–465 CrossRefPubMed
8.
Zurück zum Zitat Silva CA et al (2014) Autoimmune primary ovarian insufficiency. Autoimmun Rev 13(4–5):427–430 CrossRefPubMed Silva CA et al (2014) Autoimmune primary ovarian insufficiency. Autoimmun Rev 13(4–5):427–430 CrossRefPubMed
9.
Zurück zum Zitat Hoek A, Schoemaker J, Drexhage HA (1997) Premature ovarian failure and ovarian autoimmunity. Endocr Rev 18(1):107–134 PubMed Hoek A, Schoemaker J, Drexhage HA (1997) Premature ovarian failure and ovarian autoimmunity. Endocr Rev 18(1):107–134 PubMed
10.
Zurück zum Zitat Kim TJ et al (1997) Routine endocrine screening for patients with karyotypically normal spontaneous premature ovarian failure. Obstet Gynecol 89(5 Pt 1):777–779 CrossRefPubMed Kim TJ et al (1997) Routine endocrine screening for patients with karyotypically normal spontaneous premature ovarian failure. Obstet Gynecol 89(5 Pt 1):777–779 CrossRefPubMed
11.
Zurück zum Zitat Howell S, Shalet S (1998) Gonadal damage from chemotherapy and radiotherapy. Endocrinol Metab Clin North Am 27(4):927–943 CrossRefPubMed Howell S, Shalet S (1998) Gonadal damage from chemotherapy and radiotherapy. Endocrinol Metab Clin North Am 27(4):927–943 CrossRefPubMed
12.
Zurück zum Zitat Gracia CR et al (2012) Impact of cancer therapies on ovarian reserve. Fertil Steril 97(1):134–140.e1 CrossRefPubMed Gracia CR et al (2012) Impact of cancer therapies on ovarian reserve. Fertil Steril 97(1):134–140.e1 CrossRefPubMed
13.
Zurück zum Zitat Raffi F, Metwally M, Amer S (2012) The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab 97(9):3146–3154 CrossRefPubMed Raffi F, Metwally M, Amer S (2012) The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab 97(9):3146–3154 CrossRefPubMed
14.
Zurück zum Zitat Coccia ME et al (2011) Ovarian surgery for bilateral endometriomas influences age at menopause. Hum Reprod 26(11):3000–3007 CrossRefPubMed Coccia ME et al (2011) Ovarian surgery for bilateral endometriomas influences age at menopause. Hum Reprod 26(11):3000–3007 CrossRefPubMed
15.
Zurück zum Zitat Visvanathan N, Wyshak G (2000) Tubal ligation, menstrual changes, and menopausal symptoms. J Womens Health Gend Based Med 9(5):521–527 CrossRefPubMed Visvanathan N, Wyshak G (2000) Tubal ligation, menstrual changes, and menopausal symptoms. J Womens Health Gend Based Med 9(5):521–527 CrossRefPubMed
16.
Zurück zum Zitat Siddle N, Sarrel P, Whitehead M (1987) The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril 47(1):94–100 CrossRefPubMed Siddle N, Sarrel P, Whitehead M (1987) The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril 47(1):94–100 CrossRefPubMed
17.
Zurück zum Zitat Pokoradi AJ, Iversen L, Hannaford PC (2011) Factors associated with age of onset and type of menopause in a cohort of UK women. Am J Obstet Gynecol 205(1):34.e1–34.e13 CrossRef Pokoradi AJ, Iversen L, Hannaford PC (2011) Factors associated with age of onset and type of menopause in a cohort of UK women. Am J Obstet Gynecol 205(1):34.e1–34.e13 CrossRef
18.
Zurück zum Zitat Hamoda H, British Menopause S, Women’s Health C (2017) The British Menopause Society and Women’s Health Concern recommendations on the management of women with premature ovarian insufficiency. Post Reprod Health 23(1):22–35 CrossRefPubMed Hamoda H, British Menopause S, Women’s Health C (2017) The British Menopause Society and Women’s Health Concern recommendations on the management of women with premature ovarian insufficiency. Post Reprod Health 23(1):22–35 CrossRefPubMed
19.
Zurück zum Zitat Roeters van Lennep JE et al (2016) Cardiovascular disease risk in women with premature ovarian insufficiency: a systematic review and meta-analysis. Eur J Prev Cardiol 23(2):178–186 CrossRefPubMed Roeters van Lennep JE et al (2016) Cardiovascular disease risk in women with premature ovarian insufficiency: a systematic review and meta-analysis. Eur J Prev Cardiol 23(2):178–186 CrossRefPubMed
20.
Zurück zum Zitat Kanis JA et al (2016) A systematic review of intervention thresholds based on FRAX : a report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11(1):25 CrossRefPubMedPubMedCentral Kanis JA et al (2016) A systematic review of intervention thresholds based on FRAX : a report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11(1):25 CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Bachelot A et al (2009) Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. Eur J Endocrinol 161(1):179–187 CrossRefPubMed Bachelot A et al (2009) Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. Eur J Endocrinol 161(1):179–187 CrossRefPubMed
23.
Zurück zum Zitat Crofton PM et al (2010) Physiological versus standard sex steroid replacement in young women with premature ovarian failure: effects on bone mass acquisition and turnover. Clin Endocrinol (oxf) 73(6):707–714 CrossRef Crofton PM et al (2010) Physiological versus standard sex steroid replacement in young women with premature ovarian failure: effects on bone mass acquisition and turnover. Clin Endocrinol (oxf) 73(6):707–714 CrossRef
24.
Zurück zum Zitat Cartwright B et al (2016) Hormone replacement therapy versus the combined oral contraceptive pill in premature ovarian failure: a randomized controlled trial of the effects on bone mineral density. J Clin Endocrinol Metab 101(9):3497–3505 CrossRefPubMed Cartwright B et al (2016) Hormone replacement therapy versus the combined oral contraceptive pill in premature ovarian failure: a randomized controlled trial of the effects on bone mineral density. J Clin Endocrinol Metab 101(9):3497–3505 CrossRefPubMed
25.
Zurück zum Zitat van Kasteren YM, Schoemaker J (1999) Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy. Hum Reprod Update 5(5):483–492 CrossRefPubMed van Kasteren YM, Schoemaker J (1999) Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy. Hum Reprod Update 5(5):483–492 CrossRefPubMed
26.
Zurück zum Zitat Rocca WA et al (2007) Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology 69(11):1074–1083 CrossRefPubMed Rocca WA et al (2007) Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology 69(11):1074–1083 CrossRefPubMed
27.
Zurück zum Zitat Phung TK et al (2010) Hysterectomy, oophorectomy and risk of dementia: a nationwide historical cohort study. Dement Geriatr Cogn Disord 30(1):43–50 CrossRefPubMed Phung TK et al (2010) Hysterectomy, oophorectomy and risk of dementia: a nationwide historical cohort study. Dement Geriatr Cogn Disord 30(1):43–50 CrossRefPubMed
28.
29.
Zurück zum Zitat Langrish JP et al (2009) Cardiovascular effects of physiological and standard sex steroid replacement regimens in premature ovarian failure. Hypertension 53(5):805–811 CrossRefPubMed Langrish JP et al (2009) Cardiovascular effects of physiological and standard sex steroid replacement regimens in premature ovarian failure. Hypertension 53(5):805–811 CrossRefPubMed
30.
Zurück zum Zitat Mueck AO (2012) Postmenopausal hormone replacement therapy and cardiovascular disease: the value of transdermal estradiol and micronized progesterone. Climacteric 15(Suppl 1):11–17 CrossRefPubMed Mueck AO (2012) Postmenopausal hormone replacement therapy and cardiovascular disease: the value of transdermal estradiol and micronized progesterone. Climacteric 15(Suppl 1):11–17 CrossRefPubMed
31.
Zurück zum Zitat Davey DA (2013) HRT: some unresolved clinical issues in breast cancer, endometrial cancer and premature ovarian insufficiency. Womens Health (Lond) 9(1):59–67 CrossRef Davey DA (2013) HRT: some unresolved clinical issues in breast cancer, endometrial cancer and premature ovarian insufficiency. Womens Health (Lond) 9(1):59–67 CrossRef
32.
Zurück zum Zitat Nunnelee JD (2009) Review of an article: Canonico M, Plu-Bureau G, Lowe G, Scarabin P. (2008). Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis. British Medical Journal 10(336):1227–1231. J Vasc Nurs 27(1):17 CrossRefPubMed Nunnelee JD (2009) Review of an article: Canonico M, Plu-Bureau G, Lowe G, Scarabin P. (2008). Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis. British Medical Journal 10(336):1227–1231. J Vasc Nurs 27(1):17 CrossRefPubMed
33.
Zurück zum Zitat Canonico M et al (2010) Postmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study. Arterioscler Thromb Vasc Biol 30(2):340–345 CrossRefPubMed Canonico M et al (2010) Postmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study. Arterioscler Thromb Vasc Biol 30(2):340–345 CrossRefPubMed
Metadaten
Titel
Prämature Ovarialinsuffizienz
verfasst von
Dr. Susanna Weidlinger
Publikationsdatum
15.05.2018
Verlag
Springer Vienna
Erschienen in
Journal für Gynäkologische Endokrinologie/Schweiz / Ausgabe 2/2018
Print ISSN: 1995-6924
Elektronische ISSN: 2520-8500
DOI
https://doi.org/10.1007/s41975-018-0045-1

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