Premature Ovarian Insufficiency: An Adolescent Series

Abstract

Study ObjectiveTo study the presentation and causes of premature ovarian insufficiency (POI) in adolescents. DesignRetrospective notes review. SettingTertiary referral outpatient clinic for pediatric and adolescent gynecology. ParticipantsAdolescents with POI. InterventionsStandard POI evaluation. Main Outcome MeasuresAge and clinical symptoms at presentation, causative factors for POI, if identified. ResultsWe identified 22 girls with POI, with a mean age of 15.6 years. Eight of them presented with delayed puberty, 3 with primary amenorrhea, and the remainder presented with either irregular bleeding (n = 9) or secondary amenorrhea (n = 2). For those who presented with delayed puberty, only 3 were found to have a sex chromosome abnormality. A clear cause for the POI was identified in 3 further cases. ConclusionAlthough POI in adolescents traditionally is associated with primary amenorrhea and delayed puberty, a proportion of girls will present with irregular bleeding that might be mistaken for expected menstrual disturbances of puberty, thus delaying the diagnosis. We identified a clear cause for POI in 6 cases. Although there were no familial cases of POI, it remains a possibility that genetic reasons might be involved in the pathogenesis.