Epidemiology
Etiology
- Idiopathic (up to 70% of cases)
- Autoimmune diseases, e.g.:
- Hashimoto thyroiditis
- Adrenal insufficiency
- Autoimmune lymphocytic oophoritis
- Iatrogenic
- Radiation and/or chemotherapy
Pathophysiology
Follicular dysfunction or depletion → ↓ estrogen levels → reduced feedback inhibition of estrogen on FSH and LH → ↑ FSH and LH (usually FSH > LH)
Clinical features
- Amenorrhea or abnormal uterine bleeding
- Climacteric symptoms such as vaginal dryness, vasomotor symptoms, dyspareunia, and irritability
- Infertility
Diagnostics
- Age is < 40 years
- There has been irregular menstruation for ≥ 3 consecutive months
- ↑ FSH levels (> 30–40 mIU/mL)
- ↓ Estradiol levels (< 50 pg/mL)