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Committee Opinion No. 698 Summary: Hormone Therapy in Primary Ovarian Insufficiency.

Abstract Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. Although exogenous estrogen replacement is recommended for women with primary ovarian insufficiency, data comparing various hormonal regimens for disease prevention, symptom amelioration, and safety are lacking in this population. As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. Combined hormonal contraceptives prevent ovulation and pregnancy more reliably than HT; despite only modest odds of spontaneous pregnancy in women with primary ovarian insufficiency, this is a critical consideration for those who deem pregnancy prevention a priority. Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 50-51 years). Finally, considering the challenges that adolescents and young women may face in coping with the physical, reproductive, and social effects of primary ovarian insufficiency, comprehensive longitudinal management of this condition is essential.
PMID
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Committee Opinion No. 698: Hormone Therapy in Primary Ovarian Insufficiency.

Authors
Mayor MeshTerms
Keywords
Journal Title obstetrics and gynecology
Publication Year Start




PMID- 28426614
OWN - NLM
STAT- In-Process
DA  - 20170420
LR  - 20170420
IS  - 1873-233X (Electronic)
IS  - 0029-7844 (Linking)
VI  - 129
IP  - 5
DP  - 2017 May
TI  - Committee Opinion No. 698 Summary: Hormone Therapy in Primary Ovarian
      Insufficiency.
PG  - 963-964
LID - 10.1097/AOG.0000000000002040 [doi]
AB  - Primary ovarian insufficiency describes a spectrum of declining ovarian function 
      and reduced fecundity due to a premature decrease in initial follicle number, an 
      increase in follicle destruction, or poor follicular response to gonadotropins.
      The sequelae of primary ovarian insufficiency include vasomotor symptoms,
      urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and
      increased all-cause mortality. In women with primary ovarian insufficiency,
      systemic hormone therapy (HT) is an effective approach to treat the symptoms of
      hypoestrogenism and mitigate long-term health risks if there are no
      contraindications to treatment. Hormone therapy is indicated to reduce the risk
      of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve
      the quality of life of women with primary ovarian insufficiency. Although
      exogenous estrogen replacement is recommended for women with primary ovarian
      insufficiency, data comparing various hormonal regimens for disease prevention,
      symptom amelioration, and safety are lacking in this population. As a first-line 
      approach, HT (either orally or transdermally) that achieves replacement levels of
      estrogen is recommended. Combined hormonal contraceptives prevent ovulation and
      pregnancy more reliably than HT; despite only modest odds of spontaneous
      pregnancy in women with primary ovarian insufficiency, this is a critical
      consideration for those who deem pregnancy prevention a priority. Treatment for
      all women with primary ovarian insufficiency should continue until the average
      age of natural menopause is reached (age 50-51 years). Finally, considering the
      challenges that adolescents and young women may face in coping with the physical,
      reproductive, and social effects of primary ovarian insufficiency, comprehensive 
      longitudinal management of this condition is essential.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obstet Gynecol
JT  - Obstetrics and gynecology
JID - 0401101
EDAT- 2017/04/21 06:00
MHDA- 2017/04/21 06:00
CRDT- 2017/04/21 06:00
AID - 10.1097/AOG.0000000000002040 [doi]
AID - 00006250-201705000-00043 [pii]
PST - ppublish
SO  - Obstet Gynecol. 2017 May;129(5):963-964. doi: 10.1097/AOG.0000000000002040.

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