Multicomponent verification of diagnosis in premature ovarian failure: A retrospective study

Introduction. Premature ovarian failure (POF) is a loss of ovarian function in women under the age of 40 years.

Aim. To describe the multicomponent manifestations when verifying the diagnosis of POF using the assessment of the vaginal component in patients.

Materials and methods. We conducted a retrospective analysis of medical records from patients aged 35–40 years receiving outpatient care, divided into two groups. The test group included 38 patients with an irregular menstrual cycle (MC) with its duration more than 38 days (or the frequency of menstruation is less than 10 per year), followed by the absence of menstruation for 3 months (amenorrhea). The comparison group included 38 patients with regular MC who attended an outpatient preconception examination.

Results. Patients with POF, in addition to vasomotor symptoms and psycho-emotional disorders, have manifestations of hypoestrogenism, including symptoms of genitourinary syndrome/vulvovaginal atrophy. The concentration of Lactobacilli in the vaginal biotope in patients with POF was below the reference values (p < 0.001). In contrast, the concentration of facultative anaerobic (p < 0.001) and obligate anaerobic (p < 0.001) microorganisms, yeast-like fungi (p < 0.001), and representatives of the Mollicutes class (p < 0.001) exceeded the reference range. Therefore, the prevalence of the vagina, cervix, and vulva diseases (aerobic vaginitis, bacterial vaginosis, vulvovaginal candidiasis), for which patients with POF had 2 to 3 outpatient visits per year, was significantly higher than in patients with normal MC (p < 0.001; p < 0.001; p < 0.01). The relative risks in patients with POF were 4.3 for aerobic vaginitis, 12.1 for bacterial vaginosis, and 2.3 for vulvovaginal candidiasis.

Conclusion. The study highlights that gynecologists should recognize patients with POF may experience symptoms of genitourinary syndrome/vulvovaginal atrophy, not just vasomotor symptoms and psycho-emotional disorders, even if active vaginal symptoms are absent.