Rula V. Kanj

Case of a Girl with Primary Amenorrhea, Delayed Puberty, and High Gonadotropin Levels

Primary ovarian insufficiency (POI) is the depletion or dysfunction of ovarian follicles with cessation of menses before age 40. The condition was formerly known as premature menopause or premature ovarian failure. However, ovarian function is often intermittent and unpredictable in affected adolescents and women, and ovarian reserve is decreased rather than depleted. The diagnosis of POI is often delayed in teenagers. These patients may present with primary or secondary amenorrhea. Most cases of POI will not have an identified cause even after a complete evaluation. POI represents an example of primary hypogonadism with estrogen deficiency. One of the major medical complications can be skeletal losses and lack of bone accrual. Hormone replacement therapy is the central component of treatment. However, the optimal dose and delivery system are still under investigation. The diagnosis of POI often has effects on physical, mental, and emotional health. An interdisciplinary approach to management is recommended.