Premature Ovarian Insufficiency: An Adolescent Series

Abstract

Study Objective To study the presentation and causes of premature ovarian insufficiency (POI) in adolescents. Design Retrospective notes review. Setting Tertiary referral outpatient clinic for pediatric and adolescent gynecology. Participants Adolescents with POI. Interventions Standard POI evaluation. Main Outcome Measures Age and clinical symptoms at presentation, causative factors for POI, if identified. Results We 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. Conclusion Although 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. © 2017 North American Society for Pediatric and Adolescent Gynecolog