Premature ovarian insufficiency (POI) has not only medical but also socio-economic significance, extending far beyond the field of gynecology, and is associated with a risk of premature development of cardiovascular diseases and osteoporosis, as well as causing persistent impairment of quality of life and disability in women of early reproductive age. The aim of the study was to investigate the interrelationship of hormonal, autoimmune, and psychometric parameters in POI. Patients were divided into three groups: Group 1 (main group) included 50 women with POI; Group 2 (comparison group) consisted of 35 women with physiological menopause; Group 3 (control group) included women aged 18–40 years with a regular menstrual cycle (24–35 days) during the last 12 months. The study demonstrated that estrogen deficiency, increased follicle-stimulating hormone levels, decreased anti-Müllerian hormone levels, and the presence of autoimmune disorders exert a synergistic effect on bone metabolism, leading to the early development of osteopenia and an increased risk of osteoporosis in women of reproductive age. In addition, it was revealed that psychometric disorders in women with POI are closely associated with hormonal and metabolic changes, which emphasizes the systemic nature of the disease. Depression, anxiety, and sexual dysfunction accompany a decrease in bone mineral density, exacerbating the severity of clinical manifestations. The obtained data confirm the necessity of comprehensive rehabilitation and therapeutic programs, which will form the basis for the development of practical recommendations. In this regard, the management of women with POI requires not only correction of hormonal deficiency but also a comprehensive, multilevel approach that includes assessment of the psychoemotional state, diagnosis of autoimmune changes, and prevention of bone mass loss. Such an approach is capable of improving patients’ quality of life, reducing the risk of long-term complications, and increasing the effectiveness of therapy. The foundation of further practical recommendations should be precisely the integration of endocrinological, psychological, immunological, and rehabilitative interventions.

Premature ovarian insufficiency, autoimmune markers, thyroid gland changes

Blinov D.V., Khazan P.L., Mnatsakanyan A.N., et al. Early menopause and premature ovarian insufficiency: problems and prospects. Obstetrics, Gynecology and Reproduction. 2020; Vol. 14, No. 3. P.

Denisova V.M., Yarmolinskaya M.I., Zakuraeva K.A. Premature ovarian insufficiency: genetic causes and patient management strategies (literature review). Journal of Obstetrics and Women’s Diseases. 2021; Vol. 70, No. 3. P. 75–91. DOI: https://doi.org/10.17816/JOWD59987

Dubrovina S.O., Aleksandrina A.A. Premature ovarian insufficiency: an arsenal of approaches. Obstetrics and Gynecology. 2022; No. 3. P. 10–15. https://dx.doi.org/10.18565/aig.2022.3.13-20

Nabieva D.Yu., Kayumova D.T., Mukhitdinova T.K. Clinical and pathogenetic aspects of premature and early menopause. Approaches to correction. Medical Science of Uzbekistan. 2022; No. 1. P. 11–13.

Rshtuni S.D., Chernukha G.E., Donnikov A.E., Tabeeva G.I., Burmenskaya O.V., Marchenko L.A. Prevalence of premature ovarian insufficiency and early menopause in carriers of pathogenic BRCA1 variants. Gynecology. 2022; 24(5):374–379.

DOI:10.26442/20795696.2022.5.201688

Salimova M.D., Nadelyaeva Ya.G., Danusevich I.N. Current concepts of clinical and diagnostic criteria for premature ovarian insufficiency (literature review). Acta Biomedica Scientifica. 2020; Vol. 5, No. 6. P. 42–50.

Fakhrutdinova S.S. The role of clinical and genetic markers in predicting premature ovarian insufficiency: PhD thesis abstract. Tashkent, 2019. 97 p.

Baber R.J., Panay N., Fenton A. 2016 IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016; 19(2):10950. https://dx.doi.org/10.3109/13697137.2015.1129166.

European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI, Webber L., Davies M., Anderson R. et al. ESHRE Guideline: management of women with premature ovarian insufficiency // Hum. Reprod. 2016. Vol. 31, No. 5. P. 926–937. DOI: 10.1093/humrep/dew027

Panay N., Anderson R.A., Nappi R.E. et al. Premature ovarian insufficiency: an International Menopause Society White Paper // Climacteric. 2020. Vol. 23. No. 5. P. 426–446. DOI: 10.1080/13697137.2020.1804547

The ESHRE Guideline Group on POI, L. Webber, M. Davies, R. Anderson, J. Bartlett, D. Braat, B. Cartwright, R. Cifkova, S. de Muinck Keizer-Schrama, E. Hogervorst, F. Janse, L. Liao, V. Vlaisavljevic, C. Zillikens, N. Vermeulen, ESHRE Guideline: management of women with premature ovarian insufficiency, Human Reproduction, Volume 31, Issue 5, May 2016, Pages 926–937, https://doi.org/10.1093/humrep/dew027

Tsiligiannis S, Panay N, Stevenson JC. Premature Ovarian Insufficiency and Long-Term Health Consequences. Curr Vasc Pharmacol. 2019; 17(6): 604-609. doi: 10.2174/1570161117666190122101611

Torrealday S., Kodaman P., Pal L. Premature Ovarian In- sufficiency — an update on recent advances in understan- ding and management // F1000Res. 2017. Vol. 6. P. 2069. DOI: 10.12688/f1000research.11948.1

Webber L, Davies M, Anderson R, Bartlett J, Braat D, Cart- wright B, et al. ESHRE guideline: Management of women with premature ovarian insufficiency. Hum Reprod 2016; 31(5): 926-937. doi: 10.1093/humrep/dew027.