Pathogenesis and Factors Influencing Premature Ovarian Insufficiency among Nigerian Women

Abstract

Background: Premature ovarian insufficiency (POI) is a significant cause of infertility and hypoestrogenic symptoms in women under 40 years, with profound reproductive, endocrine, and psychosocial implications. Limited epidemiological data exist on its pathogenesis and risk determinants among Nigerian women. Objective: To investigate the pathogenesis and factors influencing POI among Nigerian women attending a tertiary hospital in southeastern Nigeria. Methods: A hospital-based descriptive cross-sectional study was conducted at Abia State University Teaching Hospital, Aba, involving 300 Nigerian women aged 18–49 years. Participants were selected using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire, physical examination, and hormonal assays. Descriptive statistics, Chi-square tests, independent t-tests, Pearson correlation, and logistic regression were performed, with significance set at p < 0.05. Results: The mean age of participants was 32.9 ± 6.4 years. Significant predictors of POI included age group (p = 0.014), history of pelvic surgery (p = 0.002), smoking status (p = 0.042), and family history of early menopause (p < 0.001). Hormonal assays revealed elevated mean FSH (48.26 ± 8.74 mIU/mL) and low estradiol (32.47 ± 11.21 pg/mL) among affected women. Age at diagnosis showed positive correlations with FSH (r = 0.312, p < 0.05) and LH (r = 0.241, p < 0.05), but negative correlation with estradiol (r = –0.298, p < 0.05). The most prevalent symptoms were hot flushes (69.67% agreeing/strongly agreeing), vaginal dryness (67.67%), and night sweats (63.00%). Conclusion: POI among Nigerian women is influenced by modifiable and non-modifiable factors, including surgical history, smoking, and familial predisposition. Hormonal patterns confirm the hypoestrogenic state. Early identification of at-risk women and targeted interventions may mitigate reproductive and health consequences.