Patient's question:
Medical Description: I would like to learn about knowledge related to slowing ovarian aging, such as: what factors are related to ovarian aging? What kind of care is effective? What should be paid attention to daily? Is it necessary to take estrogen? Etc.Doctor's answer:
Hello: Premature ovarian failure patients, in addition to amenorrhea, only a small number experience symptoms similar to menopausal syndrome. However, young women may develop uterine atrophy, reduced vaginal secretions, dyspareunia, and even osteoporosis due to prolonged hypoestrual status, so estrogen supplementation should be administered promptly. Currently, it is believed that premature ovarian failure is not necessarily irreversible, especially for patients who wish to conceive, active treatment should still be pursued.(1) Artificial cycle: Periodic estrogen-progestogen supplementation can prevent the atrophy of reproductive organ epithelium and calcium loss, while also protecting the cardiovascular system and preventing lipid metabolism changes. Estrogen can be started at any time, such as ethinyl estradiol 0.5–1 mg, once daily, for 22 consecutive days. Progestogen should be added on the 11th day of medication, such as oral medroxyprogesterone acetate (MPA, Depo-Provera) 8–10 mg, once daily, for 10 days. If progesterone injections are used, they should be started on the 16th day of estrogen intake, with a daily intramuscular injection of 10 mg, for 5 consecutive injections. If ethinyl estradiol 5 μg is taken, it should be administered once daily for 20–22 days, followed by progestogen.
(2) Inducing follicular development: After a stage of artificial cycle treatment, a low-dose estrogen alone can be used, such as ethinyl estradiol 0.5 mg or 0.25 mg (ethinyl estradiol 12.5 μg), once daily, for 3 weeks, followed by a 1-week break. Regardless of whether withdrawal bleeding occurs, the second cycle of treatment should be started, with 3 cycles constituting one course. After the estrogen level slightly rises and FSH and LH are suppressed, HMG can be appropriately used to stimulate follicular development, even ovulation.