Long term health status of POI Patients
A. Bachelot, S. Gricourt, M. Coudert, J. Dulon & P. Touraine
Premature ovarian insufficiency (POI) is a disorder which affects approximately 1% of women under 40 years of age. Besides infertility and estrogen deficiency altering the quality of life, the impact of this disease on the long-term health status of these women, especially bone status, has received little attention. We therefore designed a cross-sectional study of patients with POI, 510 years after a first evaluation in our department. We evaluated their anthropometric, hormonal replacement treatment (HRT) and bone health status. One hundred and ninety four patients were proposed to participate to this study, and 130 agreed to participate (77%). The mean follow-up period was 8±2.5 years (4.619.3). Eighty five patients had bone mineral density (BMD) determination. Forty six patients (54%) presented osteopenia, 8 osteoporosis (10%) and 31 (36%) had normal BMD. No fractures were reported. Thirty women (59%) with vitamin D deficiency exhibited bone demineralization. Forty five patients had BMD evaluation at the time of POI diagnosis and during the present evaluation. Thirteen (28.8%) of them had stopped their HRT for over a year. Twenty three (51%) had progressed to osteopenia or osteoporosis. In univariate analysis, discontinuation of HRT and POI duration were associated with a significant loss of BMD, while BMI was associated with a gain in BMD. In multivariate analysis, time since HRT discontinuation was significantly associated with a loss of BMD; BMI and occurrence of a pregnancy were associated with a gain in BMD, but POI duration had no significant impact.
In conclusion, our study was the first to analyse long-term consequences on these womens health of POI. We showed that impairment of BMD is common in POI women, especially in patients who stopped their HRT. These patients must be carefully monitored to improve their final outcome.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.