SPONTANEOUS premature ovarian insufficiency (POI), the cessation of ovarian function before age 40, affects 1% of women and can significantly impact health and quality of life. While chromosomal abnormalities, prior cancers, and surgeries like bilateral oophorectomies contribute to POI, autoimmune processes are also recognised as key factors. It is estimated that between 4% and 55% of POI cases are due to autoimmune origins, involving autoreactive T-cells and autoantibodies. Autoimmune disorders commonly associated with POI include thyroid and adrenal conditions.
Research has shown that women with POI are more likely to have autoimmune antibodies, particularly thyroid antibodies, which are linked to a heightened risk of developing POI. Low anti-Müllerian hormone (AMH) levels, indicating reduced ovarian reserve, are frequently found in women with autoimmune disorders such as type 1 diabetes, rheumatoid arthritis, and lupus. One study suggested that women with autoimmune conditions face a 2- to 5-fold increased risk of developing POI.
A large nationwide study has strengthened the understanding of the relationship between POI and autoimmune diseases. It found that women diagnosed with POI had more than double the prevalence of severe autoimmune diseases compared to the general female population, both before and after POI diagnosis. The incidence of autoimmune diseases remained elevated for over a decade following POI diagnosis.
This study contributes valuable insights into the link between POI and autoimmune mechanisms, confirming that POI patients have a long-term tendency to develop autoimmune diseases. While previous research has explored autoimmune disorders in small populations, this study’s large sample size and long follow-up period provide stronger evidence. The findings highlight the need for future studies to investigate the immunological mechanisms of POI and explore preventative and treatment options for affected women.
Reference
Savukoski SM et al. Excess of severe autoimmune diseases in women with premature ovarian insufficiency: a population-based study. Hum Reprod. Published online September 25, 2024. doi:10.1093/humrep/deae213.
