Systemic adversities of ovarian failure.

Normal human ovarian function is a complex process. Ovarian failure can lead to lack of not only female estrogenic steroids, but also progestins, androgens, protein hormones and growth factors, and oocytes themselves. In addition, the process is not abrupt or immediate but often intermittent, leading to difficulties in diagnosis and treatment. The systemic impact of ovarian failure depends on the timing of ovarian failure (before or after puberty, family building, and age-expected menopause) as well as on the specific compartments that are compromised. Although the impact of reduced estrogen secretion is generally known, the systemic effects of the losses of pregnancy, progestins, androgens, and other ovarian products remain poorly understood. Finally, the underlying diseases causing premature ovarian failure may result in additional systemic symptoms. In summary, cessation of ovarian function has many physiologic implications for women that extend far beyond the loss of estrogen secretion.