Early menopause: A hazard to a woman's health.
Early menopause: A hazard to a woman's health.
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DOI：
10.4103/0971-5916.184283
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发表时间：
2016-04
期刊：
影响因子：
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通讯作者：
Castelo-Branco C
中科院分区：
文献类型：
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作者：
Hernández-Angeles C;Castelo-Branco C
过早绝经或卵巢功能不全（POI）是妇女不孕的常见原因，影响约1%的年轻妇女。这种疾病有严重的心理后遗症和重大的健康影响。近年来，由于发达国家推迟了生育年龄，导致原发性卵巢功能不全或怀孕可能性降低，因此其相关性有所增加。主要特征是不排卵、闭经和血清促性腺激素水平高（高促性腺激素性功能减退症）。虽然病因在大多数情况下仍然不确定，但已经阐明了几种罕见的具体原因。POI的潜在原因是医源性（卵巢手术，放疗或化疗），环境因素，病毒感染，代谢和自身免疫性疾病和遗传改变。由于与其他自身免疫性疾病相关，建议对POI患者进行密切随访。评价卵巢老化的传统指标是年龄、血清激素水平、抗苗勒管激素、窦卵泡计数和卵巢超声检查。激素替代疗法仍然是治疗的主要手段，而实现怀孕的最佳机会是通过卵母细胞捐赠。本文旨在概述POI的潜在原因、临床表现和治疗方案。
Early menopause or premature ovarian insufficiency (POI) is a common cause of infertility in women and affects about one per cent of young women. This disorder has significant psychological sequelae and major health implications. Its relevance has increased in recent years due to the fact that age of motherhood is being delayed in developed countries, with the risk of having either primary ovarian insufficiency or less possibilities of pregnancy. The main characteristics are absence of ovulation, amenorrhoea and high levels of serum gonadothropins (hypergonadotropic hypogonadism). Although the aetiology remains uncertain in most cases, several rare specific causes have been elucidated. Potential causes for POI are iatrogenic (ovarian surgery, radiotherapy or chemotherapy), environmental factors, viral infections, metabolic and autoinmune diseases, and genetic alterations. Because of the association with other autoimmune diseases, close follow up is recommended in patients with POI. The traditional indicators to evaluate ovarian ageing are age, serum hormonal levels, anti-Mullerian hormone, antral follicle count, and ultrasonography of ovaries. Hormone replacement therapy remains the mainstay of treatment, and the best chance of achieving a pregnancy is through oocyte donation. This article aims to present an overview of potential causes, clinical manifestations, and treatment options of POI.