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Pathology
Amenorrhea
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Phyllodes tumor
Intrauterine growth restriction
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Benign breast conditions: Pathology review
Breast cancer: Pathology review
Cervical cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sex chromosomes: Pathology review
Disorders of sexual development and sex hormones: Pathology review
HIV and AIDS: Pathology review
Ovarian cysts and tumors: Pathology review
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Testicular and scrotal conditions: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Vaginal and vulvar disorders: Pathology review
Premature ovarian failure
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premature ovarian failure p. 652, 669
premature ovarian failure p. 652, 669
premature ovarian failure p. 652, 669
In premature ovarian failure, which is also called primary ovarian insufficiency, the ovaries stop functioning normally, and this means that they stop ovulating, or releasing egg cells, and they also stop producing hormones, mainly estrogen and progesterone, and this all happens before a woman is 40 years old. It’s considered a “primary” problem because the problem is with the ovaries themselves, rather than glands or hormones that act on the ovaries.
Normally, the hypothalamus, which is located at the base of the brain, secretes gonadotropin-releasing hormone, or GnRH. GnRH makes the nearby pituitary gland secrete two hormones of its own, called gonadotropins. These are follicle stimulating hormone, or FSH, and luteinizing hormone, or LH. These hormones travel to the follicles within the ovaries. The follicles are small clusters of granulosa and theca cells that protect the developing egg cell.
FSH acts on the granulosa cells, making the follicles grow and mature, as well as secrete estrogen, while LH stimulates theca cells to secrete progesterone and small amounts of androstenedione, which is a precursor of testosterone. All three of these hormones belong to a class of steroids, or lipid-soluble hormones.
At birth, a woman has millions of follicles, each ready and excited to do its job. During puberty, the monthly menstrual and ovarian cycles begin, which is when the endometrium, or inner lining of the uterus, goes through cyclic changes in response to the ovarian hormones.
During the ovarian cycle, the ovarian hormones also help a handful of follicles to start growing. Eventually, there’s ovulation which is when a single follicle fully matures and ruptures, releasing its egg cell, while the other follicles degenerate and die off.
Premature ovarian failure (POF) is a condition in which a woman's ovaries stop functioning before age 40. This can lead to symptoms that mimic menopause, but some women with intermittent ovarian function are still able to spontaneously get pregnant. Some cases of POF are attributed to autoimmune disorders, others to genetic disorders such as Turner syndrome and Fragile X syndrome. Symptoms of POF can include irregular or absent menstrual periods, hot flashes, night sweats, vaginal dryness, and reduced fertility. Treatment involves the replacement of the hormones that the ovaries have stopped producing, especially estrogen and progesterone. For women who struggle with infertility, in-vitro fertilization can be used.
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