PREMATURE ovarian insufficiency (POI), characterised by the loss of ovarian function before age 40, affects 1% of women and can lead to various health complications. Recent research highlights a significant association between POI and autoimmune diseases, both before, and after, POI diagnosis.
In a study that tracked 3,972 women diagnosed with spontaneous POI and 15,708 matched controls, the prevalence of autoimmune disorders was notably higher in those with POI. Some of the most significant associations included Addison’s disease, vasculitis, and rheumatoid arthritis. Importantly, even after POI diagnosis, the risk of developing new autoimmune conditions remained elevated for up to 12 years.
Women with POI were found to be 2.6 times more likely to have had a severe autoimmune disease before their POI diagnosis compared to matched female controls. Furthermore, they also faced a 2- to 3-fold increased risk of developing autoimmune diseases for several years following their diagnosis. This supports the growing body of evidence suggesting that autoimmune mechanisms play a critical role in the development of POI.
Autoimmunity has long been suspected as a contributor to POI, with previous estimates suggesting 4–50% of POI cases may have an autoimmune origin. Conditions such as thyroid disorders, systemic lupus erythematosus, and rheumatoid arthritis have been commonly linked to POI. These conditions often manifest as autoreactive T-cells and organ-specific or non-organ-specific autoantibodies, which may also impact ovarian function.
The findings underscore the importance of recognising the role of autoimmune disorders in POI pathogenesis. Future research should explore the specific mechanisms involved, to identify preventive and curative strategies to mitigate the long-term health impacts of POI on women at risk.
Katie Wright, EMJ
Reference
Savukoski SM et al. Excess of severe autoimmune diseases in women with premature ovarian insufficiency: a population-based study. Hum Reprod. 2024;DOI:10.1093/humrep/deae213.
