BMJ Case Reports: Premature ovarian failure 16-year-old girl following human papillomavirus vaccination
- Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
+ Author Affiliations
- 1Department of General Practice, North Bellingen Medical Services, Bellingen, Australia
- 2Department of Obstetrics and Gynaecology, The University of New South Wales Rural Medical School in Coffs Harbour, Coffs Harbour, Australia
- Correspondence to Dr Deirdre Therese Little, [email protected]
Premature ovarian failure in a well adolescent is a rare event. Its occurrence raises important questions about causation, which may signal other systemic concerns. This patient presented with amenorrhoea after identifying a change from her regular cycle to irregular and scant periods following vaccinations against human papillomavirus. She declined the oral contraceptives initially prescribed for amenorrhoea. The diagnostic tasks were to determine the reason for her secondary amenorrhoea and then to investigate for possible causes of the premature ovarian failure identified. Although the cause is unknown in 90% of cases, the remaining chief identifiable causes of this condition were excluded. Premature ovarian failure was then notified as a possible adverse event following this vaccination. The young woman was counselled regarding preservation of bone density, reproductive implications and relevant follow-up. This event could hold potential implications for population health and prompts further inquiry.
Apparently it was this woman's refusal to take the pill that helped them to isolate the factors in ovarian failure and have to consider the hpv vaccination more singularly. I suppose this will be more and more the case as this vaccine is recommended to girls who are very young and they will not be wanting to go on the pill.
Posted by: jen | October 15, 2012 at 08:51 PM