Endocrine Abstracts

Introduction: The average age for physiological menopause is 50 years. Menopause before the age of 40 is usually defined as premature ovarian failure (POF). POF in adolescents is an extremely rare event and its occurrence raises important questions about the cause-and-effect relationship, which may signal genetic and systemic disorders.

Design Case report: The 29-year-old first reported to an endocrinologist for secondary amenorrhea. The anamnesis revealed that the patient got menarche at the age of 10. She had regular menstrual cycles for 4 years and irregular periods for 2 years. After the age of 16 she stopped menstruating. After 6 months, the therapy was excluded and during the next period of 12.5 years until the appearance of the endocrinologist and the desire to have children, she did not take anything from the therapy. From hardship allegations; irritability, insomnia, lack of energy, loss of libido, sweating, headache and weight gain. Menopause in a mother from the age of 30. Hormonal analyses:hypergonadotropic hypogonadism (FSH 200 mIU/l, LH 29.34 mIU/l, estradiol<7 pg/ml, AMH0.01 ng/ml). Ultrasonography of the pelvis showed a normally located and normally developed uterus with a 4.7mm thin endometrium and both ovaries of reduced dimensions. Chronic autoimmune thyroiditis with elevated antibodies to thyroid peroxidase and thyroglobulin, but euthyroid with thyroid hormones in the normal range, was detected in the patient by ultrasonography. Testing did not detect congenital and acquired trobophilia. Karyotype: 46XX. Genetic analysis of FMMR1 genes normal. Ovarian antibodies negative. Introduced replacement therapy with oral estrogen-progestogens with the addition of estradiol at a dose of 2 mg in the follicular phase of the menstrual cycle, D3 hormone, antioxidants. After 2 years of treatment : FSH 28 mIU/l, LH 19.1 mIU/l, estradiol 22.4 pg/ml). Spontaneous abortion in the 6th week of gestation after in vitro fertilization with donated eggs.

Conclusion: Most cases of P0F remain idiopathic with a reduced success rate of assisted reproduction and procreation. The goal of treating adolescents with POF is replacement therapy with higher doses of estrogen than menopausal women to ensure proper replacement and optimal bone health. Keywords: premature ovarian failure, secondary amenorrhea, hypergonadotropic hypogonadism