Identification of differing etiologies of clinically diagnosed premature menopause

Adrenal and ovarian autoimmunity

“…Lymphocytic oophoritis is an exceptional finding in these patients as it has been described in only 6/198 patients with POF not associated with AAD, while in the majority, follicular activity without evidence of lymphocytic infiltration was found (95,(101)(102)(103)(104)(105)(106)(107)(108)(109)(110)(111)(112)(113)(114)(115)(116). These data indicate that the absence of lymphocytic oophoritis cannot be regarded as conclusive evidence against an autoimmune aetiology, as this could equally be due to immunological mechanisms, such as blocking antibodies hypothesized for Savage's syndrome.…”

Analysis of FOXO3 mutation in 114 Chinese women with premature ovarian failure

“…Previous studies suggested that intrinsic abnormalities of (or damage to) primordial follicles affecting their initial recruitment or survival are the unifying pathophysiology for POF (Board et al, 1979;Russell et al, 1982;Zarate et al, 1970). Defects in the normal physiological processes that deplete primordial follicles probably play a major role.…”

Myasthenia gravis and premature ovarian failure

“…1,20 Fewer than 1% of patients with premature ovarian failure also develop myasthenia gravis. 1,3,5,12,15,21 The two disorders may present virtually simultaneously, 1 or may be separated by intervals as long as 13 years. 20 This comorbidity likely represents more than a chance association of disorders of impaired immunoregulation.…”

“…The association of premature ovarian failure with myasthenia gravis is rare but has occasionally been reported. 1,3,12,15,21 Premature menopause is defined as ovarian failure after puberty and before the age of 40 years. 7 Affected women present with amenorrhea, infertility, and symptoms of hypoestrogenism.…”

“…The association of premature ovarian failure and myasthenia gravis has only rarely been previously reported. 1,3,12,15,21 Such comorbidity is thought to relate to generalized autoimmune disease, but in most reported cases antibody status has not been defined. …”