Epidemiology
POF occurs in approximately 1 in 250 women by age 35, and 1 in 100 women before the age of 40.[2] One study suggested that, in the US, the risk of POF is lower in women of Asian and African descent and higher in white women.[3] In women presenting with secondary amenorrhea, POF will be diagnosed in 4% to 18%.[4] The average age of menopause (51 years), unlike the average age of menarche, has remained constant in the US for the last century, suggesting a genetic determination for cessation of ovarian function.[5] At least 1 in 8 women undergo surgical removal of both ovaries prior to natural menopause, most commonly at the time of hysterectomy.[6] Oophorectomy is performed for both malignant and benign indications, including breast and ovarian cancer prophylaxis. An increasing number of women of reproductive age are survivors of cancer. They may encounter POF as a consequence of chemotherapy or radiation therapy. The likelihood of ovarian failure depends on the doses and treatment regimens used.[7]
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