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Meeting the Needs of Young Women With Secondary Amenorrhea and Spontaneous Premature Ovarian Failure

From the Section on Women’s Health Research, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

Address reprint requests to: Lawrence M. Nelson, MD, MBA, National Institutes of Health, National Institute of Child Health and Human Development, Section on Women’s Health Research, Developmental Endocrinology Branch, Building 10, Room 10N262, Bethesda, MD 20892-1862; E-mail: lawrence_nelson{at}nih.gov.

OBJECTIVE: To investigate the experiences of young women with spontaneous premature ovarian failure with regard to the initial presenting symptom, promptness of diagnosis, and patient education.

METHODS: We asked 50 patients previously diagnosed with spontaneous premature ovarian failure to participate in a structured interview survey consisting of 38 true-or-false, multiple-choice, and open-ended questions.

RESULTS: Disturbance in menstrual pattern was the most common initial symptom in the 48 women who completed the interview (44 of 48, 92%). Over half of the 44 women who presented with this complaint reported visiting a clinician’s office three or more times before laboratory testing was performed to determine the diagnosis. Over half of them reported seeing three or more different clinicians before diagnosis. In 25% of women it took longer than 5 years for the diagnosis of premature ovarian failure to be established. Patients who spent more than 5 minutes with the clinician discussing the diagnosis were significantly more likely to be satisfied with the manner in which they were informed (P < .001). Ninety percent of participants were college graduates, and 40% had graduate degrees.

CONCLUSION: Women with spontaneous premature ovarian failure perceived a need for more aggressive evaluation of secondary amenorrhea and oligomenorrhea. Loss of menstrual regularity can be a sign of ovarian insufficiency, and the associated estrogen deficiency is a well-established risk factor for osteoporosis.