The HEALTH : August 2018 | Page 25

wonder women AUGUST, 2018 | The HEALTH Primary Ovarian Insufficiency (POI) KADINIZ.COM P OI is the depletion or impaired function of ovarian follicles with cessation of menses before age 40 years. In most patients, the causes are usually unknown. University of Malaya, Faculty of Medi- cine Department of Medicine senior lecturer and consultant Endocrinologist Dr Lee Ling Lim explained that other possible causes include: • Chromosomal abnormalities such as Fragile X Syndrome • Co-occurrence with certain hormonal disorders such as low parathyroid/ adrenal/thyroid hormones (usually antibodies-related) • Autoimmune: presence of ovarian antibodies • Damage to the ovaries after chemo- therapy or radiation therapy “Adolescents or young women are usually affected by POI. The most common symptoms is the presence of irregular menses for at least three months, after excluding the use of birth control pills and other hormonal disorders that can affect the menstrual cycle such as high prolactin level and low thyroid hormones. The presence of family history of premature menopause is also suggestive.” The basic blood tests include FSH and oestrogen levels – two random tests which are a month apart, prolactin level and thyroid hormones test. Pure decadence Treatment Affected individuals tend to be co-man- aged by the endocrinologists, fertility specialists and paediatricians specialised in growth and development. Hormonal therapy is used to replace the oestrogens (female hormone) until the natural age of menopause, for optimal bone health, pubertal growth and sexual maturation, as well as prevention of cardiovascular disease. For the latter, additional strategies include dietary control, regular exercise and smoking cessation. Individuals need to be referred to fertility specialists for advice on the reproductive techniques. DARK chocolates in reason- able amounts is associated with few positive health outcomes such as reduced blood pressure, increased circulation and keeping bad cholesterol down. Quality dark chocolate with a high cocoa content contains a decent amount of soluble fiber, loaded with minerals is actually quite nutritious. However, moderation is advised with no more than one ounce a day. 25