Caused by either ovarian impairment or dysregulation of gonadotropin cyclic secretion.
Most cases of ovarian dysfunction is related to autoimmune destruction of the ovary, chemotherapy agents, pelvic radiation, or genetic abnormalities such as Turner’s syndrome.
Lesions of the hypothalamus, pituitary, malnutrition, excessive energy expenditure, endocrine abnormalities of thyroid function, hyperprolactinemia, hypercortisolemia, growth hormone excess, adrenal hyperplasia, ovarian neoplasms, or hyperplasia, and uses of estrogens, progestational agents, androgens and polycystic ovarian syndrome can be associated with suppression or disruption of gonadotropin release.
Chemotherapy can produce early menopause and infertility.
Chemotherapy induced ovarian failure is caused by apoptotic oocyte–in primordial follicles, damaging ovary reserve and int2242upting the follicle recruitment and maturation.
Almost all women develop chemotherapy induced amenorrhea.
Chemotherapy induced amenorrhea for women younger than 40 years of age with early breast cancer occurs in about 40% of cases, compared with 76% in older women.
Alkylating agents are associated with the highest risk of ovarian failure, reaching as high as 90% of women older than 40 years.
Current chemotherapy regimens have less ovarian toxicity, with lower rates of permanent amenorrhea, with one report suggesting 85% of women 40 years and younger recovering their menses at 1 year (Fornier MN et al).