General health issues in women diagnozed with POI

Blazej Meczekalski (PL)

[Meczekalski] Poznan Univeristy of Medical Sciences

Premature ovarian insufficiency (POI) is status related to profound hypoestrogenism. It is described as cessation of ovarian function before the age of 40 years and has important impact on women’s health. Etiology of POI imay be related to: genetic or metabolic abnormalities, autoimmune disorders, iatrogenic or idiopathic. The lack of ovarian function and estradiol synthesis causes serious consequences. The short-term effects are well known, and resemble the course of natural menopause. Due to younger age of affected population, in contrast to natural menopause, POI is related to specific general health issues. Natural reproduction is practically impossible. Estrogen loss leads also to atrophy of urinary and vaginal mucosa. The most common urogenital symptoms include vaginal dryness and dyspareunia. The data regarding urinary incontinence is limited so far. POI patients’ presents also decreased sexual performance and lower scores in sexual functioning tests. The serious complication of POI is decrease of bone mineral density (BMD) and the risk of osteoporosis and fractures. It has been shown that POI women presents several risk factors for cardiovascular disease including: endothelial dysfunction, autonomic dysfunction, abnormal lipid pro le, insulin action disturbances and metabolic syndrome. Cardiovascular disease is also related to increased mortality among POI patients. Cancer risk in POI patients is a complex issue, but some studies showed reduced risk of breast cancer. POI women experience also psychological distress and some studies showed increased risk of neurological diseases. The long-term consequences should be carefully analyzed in each case of POI and taken into account in individual management.