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Prämature Ovarialinsuffizienz

Premature ovarian failure

  • CME Weiterbildung · Zertifizierte Fortbildung
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Zusammenfassung

Unter einer prämaturen Ovarialinsuffizienz versteht man graduelle Veränderungen bis zum Komplettbild einer hypergonadotropen Amenorrhö mit Östrogenmangel. Andere Begriffe, z. B. prämature Menopause, sind irreführend und teilweise falsch und stigmatisierend. Die Ursachenklärung sollte eine eingehende Anamnese beinhalten (Ovarchirurgie, Chemotherapie, Radiatio, familiäre Disposition) und die Abklärung genetischer Faktoren (Chromosomenanalyse) und von Polyendokrinopathien beinhalten.

Die Therapie ohne und mit Kinderwunsch muss differenziert bewertet werden. Hier kommt der Hormontherapie ein hoher Stellenwert zur Prävention von Folgeerkrankungen zu. Die Nutzen-Risiko-Abwägung ist eine gänzlich andere als die bei einer Hormontherapie in der Peri- oder Postmenopause.

Insgesamt stellt die Diagnose einer prämaturen Ovarialinsuffizienz für die Patientin eine erhebliche psychische Belastung dar, v. a. bei noch nicht abgeschlossener Familienplanung.

Abstract

Premature ovarian failure describes different degrees in the gradual decline of the ovarian reserve and activity. The term “premature menopause” or similar descriptions do not describe the clinical problems and consequences sufficiently and should be avoided.

A detailed history should be obtained (ovarian surgery, chemotherapy, radiation, family history of early menopause or premature ovarian insufficiency). Furthermore, genetic causes should be clarified (chromosome analysis). Autoimmune diseases must be excluded, since they can be other parts of a polyendocrine syndrome.

The therapy with and without family planning is discussed. Hormone therapy has a completely different risk-benefit ratio as compared to peri- or postmenopausal situations. The principles for patient care in this special situation are summarized, since the diagnosis of premature ovarian insufficiency can have a severe impact on the psychological as well as somatic health of the patient.

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  1. Zentrum für Hormon- und Stoffwechselerkrankungen, Gynäkologische Endokrinologie und Pränatale Medizin, Endokrinologikum Hamburg, Hamburg, Deutschland

    M. Ludwig

  2. Abteilung für Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitätsklinikum Heidelberg, Voßstr. 9, 69115, Heidelberg, Deutschland

    T. Strowitzki

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Ludwig, M., Strowitzki, T. Prämature Ovarialinsuffizienz. Gynäkologe 43, 685–695 (2010). https://doi.org/10.1007/s00129-010-2601-x

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