Obstet Gynecol. 2014 Jul;124(1):193-197. doi: 10.1097/01.AOG.0000451757.51964.98.
Primary ovarian insufficiency is the depletion or dysfunction of ovarian follicles with cessation of menses before age 40 years. There is no consensus on criteria to identify primary ovarian insufficiency in adolescents, and delay in diagnosis is common. Health care providers who make this clinical diagnosis should be mindful of the sensitive nature of this medical condition. Patients and their families should be counseled on the effect of the patient's condition on future fertility, on the risk of comorbidities associated with primary ovarian insufficiency, and on the condition's potential for genetic inheritance. Psychologic counseling also should be offered because impaired self-esteem and emotional distress have been reported after diagnosis of primary ovarian insufficiency. Once primary ovarian insufficiency is diagnosed, patients should be evaluated at least annually. The goals of hormonal therapy extend beyond simply symptom relief to levels that support bone, cardiovascular, and sexual health. Referrals to a reproductive endocrinology and infertility specialist should be made when desired by the patient and family to further discuss available reproductive treatments.
原发性卵巢功能不全是指 40 岁以前卵巢卵泡耗竭或功能障碍导致月经停止。目前尚无确定青少年原发性卵巢功能不全的标准，且诊断常常被延误。做出该临床诊断的医护人员应意识到这种医疗状况的敏感性。应告知患者及其家属患者病情对未来生育能力的影响、与原发性卵巢功能不全相关的合并症风险，以及该病症的潜在遗传继承性。还应提供心理辅导，因为原发性卵巢功能不全诊断后，据报道患者会自尊心受损和情绪困扰。一旦确诊原发性卵巢功能不全，患者应至少每年评估一次。激素治疗的目标不仅要缓解症状，还要达到支持骨骼、心血管和性健康的水平。如果患者和家属希望进一步讨论可用的生殖治疗方法，应转至生殖内分泌和不孕专家处就诊。
