Disorders of the Ovary

This chapter describes the ovarian disorders Primary Ovarian Insufficiency (POI) and Polycystic Ovary Syndrome (PCOS). POI occurs in 1% of young women, defined by lack of periods for 4 months in women under 40 years of age with a high FSH on 2 occasions. This has implications for fertility, physical health, and psychosocial wellbeing. In 10% of women with this condition, POI is early-onset, presenting in adolescence with absent puberty and/or primary amenorrhea. With a focus on early-onset POI, we describe the aetiology, diagnosis and management aspects of POI such as fertility, associated autoimmune conditions, and bone health. PCOS is a common endocrine disorder affecting 3-8% of young women. It can be hard to define in adolescence. It is a heterogenous condition characterised by signs and symptoms of androgen excess, ovarian dysfunction, and polycystic ovarian morphology. In addition, there is a wide range of associated co-morbidities including obesity, insulin resistance, non-alcoholic fatty liver disease, and cardiovascular disease. We describe specific aetiology, diagnosis and management aspects for adolescents and young adults.