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Premature ovarian failure (POF) affects 1-3.5% of women under 40 years of age, characterized by irreversible depletion of the follicular pool and decline in oocyte quality, with its pathogenesis remaining incompletely understood. Current mainstream therapies, such as hormone replacement therapy, only alleviate symptoms, fail to reverse the underlying functional decline, and carry long-term risks, necessitating the exploration of novel strategies targeting the etiology. This review systematically dissects the central role of epigenetic regulation in POF. First, DNA methylation governs female reproductive lifespan by reprogramming the dormant-activation balance of primordial follicles and maintaining epigenetic memory in oocytes. Second, histone modification homeostasis determines ovarian endocrine function by influencing granulosa cell senescence and steroid hormone synthesis. Additionally, non-coding RNAs form regulatory hubs by constructing competing endogenous RNA networks that integrate oxidative stress and developmental signaling pathways. These mechanisms provide new insights into the pathological basis of POF, identify potential biomarkers, and offer a theoretical framework for deciphering targeted intervention strategies and developing precision epigenetic therapies to delay POF progression.
Li et al. (Mon,) studied this question.