Learning that she has what used to be called premature menopause can devastate a woman in her 20s or 30s. Diagnose this mysterious condition without delay, deliver the bad news in person, and provide sensitiveanswers to four basic questions.
Spontaneous POF-the development of amenorrhea, sex hormone deficiency, and elevated serum gonadotropin levels before age 40-affects about 1% of women.1 For the women with this disordered menstrual pattern whom we've seen at the National Institutes of Health (NIH) Clinical Center, the median age of onset is 25 years.2 The term "spontaneous" means that the ovarian failure wasn't induced by chemotherapy, radiation therapy, or surgery. In the majority of cases the disturbance in menstrual regularity is a secondary development, as most of these patients have experienced normal puberty with menarche and the development of secondary sexual characteristics.2,3
Patients often complain about how long it took them to get a diagnosis of POF. Certainly, the first clinical challenge is to diagnose this disorder early on (Table 1).
Do the right tests. Readily available commercial assays make it possible to quantify circulating steroid and protein hormone levels, enabling us to differentiate patients with amenorrhea into distinct etiologic categories. In 1990 Rebar and Connolly recommended laboratory evaluation for all women with amenorrhea to identify women with spontaneous POF or other types of amenorrhea.3 Although a complete discussion about the differential diagnosis of secondary amenorrhea is beyond the scope of this review, a careful history and physical examination can lead to an appropriately targeted evaluation.4
No link found between antenatal corticosteroids and child neurodevelopment
April 25th 2024A recent study found no link between antenatal corticosteroid administration and adverse neurodevelopmental outcomes in children aged 6 years or older, offering reassurance for late preterm delivery practices.
Read More
Hyperoxygenation use not linked to neonatal outcomes
April 23rd 2024Recent research evaluated the impact of maternal hyperoxygenation on neonatal Apgar scores, revealing no significant enhancement in outcomes among women with pathologic fetal heart rate tracing and suggesting limited efficacy of hyperoxygenation therapy in this context.
Read More
The benefits of concurrent fetal and maternal heart rate monitoring
April 15th 2024A recent study revealed that employing maternal heart rate monitoring alongside fetal heart rate monitoring during labor significantly decreases the incidence of neonatal encephalopathy and severe neonatal acidemia.
Read More
How vitamin C intake in pregnant smokers impacts offspring airway function trajectory
April 12th 2024Investigating the impact of prenatal vitamin C supplementation on lung function and wheeze occurrence in offspring of pregnant smokers, revealing insights into mitigating respiratory risks.
Read More