Premature ovarian insufficiency (POI) is characterized by cessation of ovarian function before the age of 40. Variable clinical presentation often postpones the diagnosis. The aim of our study was to assess whether there is a typical menstrual cycles pattern in patients with POI. We have evaluated 101 women, age 36.7±5.78 y. FSH=78.81±37.43 IU/l, E2<50 pg/dl, with confirmed POI referred to our Clinic between 2014 and 2018. Menstrual cycles characteristics were defined according to the pattern of cessation: abrupt (amenorrhoea) or gradual. Gradual pattern was defined according to the length as: shortened (<26 days), prolonged (>33 days) or variable (first shortened than prolonged) and according to the quality of menstrual bleeding: normal, scarlet or heavy. Also, we have grouped our patients according to the age: <35 (age 27.9±4.7 FSH=27.95±4.76 IU/l) and 3540 (age 37.53±1.90, FSH=37.52±1.89 IU/l) years. Besides aforementioned and the basic anthropometric measurements (height, weight, waist to hip ratio, body mass index (BMI)) we have collected the information about the age of menarche and the age of mothers menopause. Overall, the most frequent pattern of menstrual cessation was gradual (P<0.001). However, in the group of patients <35 y. there was a substantial number of patients with the abrupt cessation of menstrual cycle. Overall, patients had significantly higher number of prolonged (P<0.01) and heavy menstrual cycles (P<0.001) when compared to other types of menstrual cycle length and quality. When analyzed according to age, there was no significant difference in aforementioned parameters. According to the anthropometric measurements the older group had significantly higher waist (P=0.025) and hip circumference (P=0.030) and significantly higher BMI (23.29 vs 20.84 kg/m2). There was no significant difference between the groups according to the age of menarche or age of mothers menopause. The results of our study show that patients with POI are expected to have gradual onset of menstrual cessation with prolonged menstrual cycles and heavy bleedings. However, when it comes to patients under 35 years of age it is important to bare in mind that even one missed cycle in women with previously regular menstrual cycles maybe a sign of POI.
18 - 21 May 2019
European Society of Endocrinology