Endocrine Abstracts

Introduction: The therapeutic management of premature ovarian failure (POF) consists of a hormone replacement therapy that must be regular to avoid cardiovascular and bone complications as well as psychological management. The objective of this work was to study complications at 15 years of evolution of 42 tunisian women followed for POF.

Patients and methods: It’s a retrospective study of 42 patients followed in the endocrinology department of Sousse for POF between 2000 and 2017.

Results: The average age of the patients was 23.85 years old. All patients were treated with combined estrogen/progestin hormone replacement therapy with a sequential regimen in 11 patients to ensure withdrawal bleeding. After 15 years of follow-up on average, a final small height was found in 5 patients with an average height of 147.85 cm. The average body mass index was 24.51 kg/m². The average waist circumference was 90,5 cm. Three patients became diabetic, one patient was followed for hypertension and one patient was followed for dyslipidemia. Metabolic syndrome criteria were met in one third of patients. No patient had a cardiovascular event. Bone densitometry showed osteoporosis in 21.43% of patients and osteopenia in 35.71% of patients. Two patients had pathological fracture at the age of 28 and 39, respectively. Therapeutic non-compliance of hormone replacement therapy was observed in 20% of patients.

Conclusion: The two major risks of hypoestrogenism secondary to POF are cardiovascular risk and bone risk. If the patient is substituted, these risks should be avoided. However, few studies have prospectively evaluated the effects of estrogen therapy on cardiovascular risk in patients with POF.