Hormonal and Clinical Correlates of Premature Ovarian Failure: A Cross-Sectional Analysis of Diagnostic Markers and Symptom Burden”

Abstract

Premature ovarian failure (POF), characterized by amenorrhea, hypoestrogenism, and elevated gonadotropins before the age of 40, poses significant reproductive and psychosocial challenges. This cross-sectional study aimed to evaluate the diagnostic utility of hormonal biomarkers and assess symptom prevalence among women with suspected POF. A total of 112 women were enrolled, comprising 56 diagnosed with POF and 56 age-matched controls. Serum levels of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol, and inhibin B were measured. Multivariate logistic regression identified AMH <0.5 ng/mL (AOR: 13.2) and FSH >25 IU/L (AOR: 10.4) as the most significant predictors of POF. ROC curve analysis demonstrated that AMH had the highest diagnostic accuracy (AUC: 0.962), followed by FSH (AUC: 0.948), estradiol (AUC: 0.902), and inhibin B (AUC: 0.881). Clinically, infertility complaints (82.1%) and vasomotor symptoms such as hot flashes (78.6%) and vaginal dryness (65.2%) were prominent, alongside psychological symptoms like mood disturbances (54.5%) and sleep disturbances (49.1%). Symptom frequencies were significantly higher in the POF group than in controls (p < 0.05). These findings underscore the value of combining hormonal markers—particularly AMH and FSH—for early detection and diagnosis of POF. Furthermore, the high prevalence of distressing symptoms highlights the importance of holistic clinical care addressing both endocrine dysfunction and quality-of-life impairments. This study supports a multidimensional approach to POF evaluation, integrating biochemical assessment and symptom profiling to enhance diagnostic precision and guide personalized management strategies.