Abbildung 1: Hypergonadotropic hypogonadism
Possible mechanisms of hypergonadotropic hypogonadism in females. (A) In normal ovaries maturation of follicles is beginning at the time of puberty. (B) In case of maturation arrest only primordial or primary follicles are present. Basic estradiol production of granulosa cells makes breast development possible, but there is a primary amenorrhea. FSHβ-, FSHR- or LHR-mutations can cause such a condition. (C) In secondary POF, maturation of follicles at puberty makes menarche and breast development possible, but early depletion of follicles causes secondary amenorrhea. Such a condition can be caused by Turner mosaicism. (D) In primary POF, depletion of follicles before the puberty causes primary amenorrhea. Breast development is not possible. (E) In gonadal dysgenesis degeneration of the follicles occurs during fetal life. In the rule, primary POF and gonadal dysgenesis cannot be delineated clinically.