Premature Ovarian Insufficiency

“Premature ovarian insufficiency (POI)
is a condition defined by
loss of ovarian activity before the age of 40 years”.1

Umbrella

What may the Premature Ovarian Insufficiency Umbrella include?

Depending on the Source (DotS) this umbrella may include:

  • Impending Menopause
  • Premature Ovarian Failure (POF)
  • Premature Ovarian Insufficiency (POI)
  • Primary Ovarian Insufficiency (POI)

Premature Ovarian Insufficiency

What is premature ovarian insufficiency (POI) or primary ovarian insufficiency?

DotS the definition of POI may vary. On page 26 in the Guideline on Premature Ovarian Insufficiency: Guideline Group Statement, published online 08 December 2024, the ESHRE, ASRM, CREWHIRL and IMS Guideline Group on POI’s definition is:

Premature Ovarian Insufficiency“Premature ovarian insufficiency (POI) is a condition defined by loss of ovarian activity before the age of 40 years.

POI is characterised by amenorrhea or irregular menstrual cycles with elevated gonadotropins and low estradiol”.2

What is ESHRE, ASRM, CREWHIRL and IMS?

In the context above, these abbreviations stand for the:

Premature Menopause

Is premature menopause the same as POI?

In Primary Ovarian Insufficiency: Symptoms & Causes – Overview the (United States) Mayo Clinic note:

“Sometimes, primary ovarian insufficiency is confused with premature menopause. But they aren’t the same. People with primary ovarian insufficiency can have irregular or occasional periods for years. They might even get pregnant. But people with premature menopause stop having periods and can’t become pregnant”.3

POI Common or Not

How common is POI?

In Premature Ovarian Insufficiency: How Common Is Premature Ovarian Insufficiency? You and Your Hormones, the (United States) Society for Endocrinology elaborate on:

“It is relatively uncommon, occurring in one in 1,000 women under the age of 30 years and 1-4% of women under the age of 40 years. Early menopause (40-45 years) occurs in up to 4-12% of women”.4

POI Symptoms

What may be POI symptoms?

In Premature Ovarian Insufficiency (POI): Summary – What Are the Symptoms of Primary Ovarian Insufficiency (POI)? according to the (United States) Medline Plus:

“The first sign of POI is usually irregular or missed periods. Later symptoms may be similar to those of natural menopause:

  • Hot flashes
  • Night sweats
  • Irritability
  • Poor concentration
  • Decreased sex drive
  • Pain during sex
  • Vaginal dryness

For many women with POI, trouble getting pregnant or infertility is the reason they go to their health care provider”.5

Hormone Therapy

Is there a role for HT for women with POI?

In the British Menopause Society’s BMS Consensus Statement Premature Ovarian Insufficiency: Summary of Recommendations, reviewed March 2024, one of the recommendations is:

“Women with POI are at increased risk of cardiovascular disease, osteoporosis and cognitive impairment. Sex steroid hormone replacement is likely to lower the long-term risk of cardiovascular disease in women with POI, prevent osteoporosis and have a beneficial effect on cognitive function”.6

On page four of Menopause and Menopause Hormone Therapy: 2. What Is MHT? the International Menopause Society’s (IMS) Leaflet for Women for World Menopause Day 2024, the IMS note:

Premature Ovarian Insufficiency“MHT is also recommended for:

  • Premature Ovarian Insufficiency: When menopause happens before the age of 40. Even if there are no symptoms, MHT helps protect against conditions like osteoporosis (weak bones), heart disease, and brain issues”.7

POI and Pregnancy

Can women with POI become pregnant?

In Premature and Early Menopause: What Causes Premature and Early Menopause? How Does POI Affect Fertility? the (Australian) Jean Hailes for Women’s Health explain:

“If you have been diagnosed with POI and don’t want to get pregnant, you should use contraception. Many women are unable to conceive a baby naturally after POI, but there is a one in 50 chance of pregnancy”.8

Chronic Disease

Is there an association between POI and chronic disease?

In Optimising Health After Early Menopause: Summary, published 05 March 2024, a paper included in The Lancet: Series From the Lancet Journal – Menopause 2024 also published on 05 March 2024, the authors note:

“Both early menopause and premature ovarian insufficiency can herald an increased risk of chronic disease, including osteoporosis and cardiovascular disease”.9

POI Guideline 2024

What is the POI Guideline published October 2024?

According to the International Menopause Society in Update of the 2015 Evidence Based Guideline on Premature Ovarian Insufficiency – Now Published:

“To improve the care of women with POI, an international expert group, including representation from ESHRE, ASRM, CRE-WHiRL and IMS collaborated to address 40 key questions through 145 recommendations”.10

In Guideline on Premature Ovarian Insufficiency the European Society of Human Reproduction and Embryology (ESHRE) explain:

Premature Ovarian Insufficiency“This updated guideline offers best practice recommendations for the care of women with with both primary and secondary premature ovarian insufficiency (POI). POI is a clinical condition defined by the loss of ovarian function indicated by irregular menstrual cycles together with biochemical confirmation of ovarian insufficiency before the age of 40”.11

In International Monash Partnership Announced for Premature Ovarian Insufficiency Guidelines, dated 10 December 2024, the authors elaborate on:

“The 2024 guidelines provide 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of POI. The recommendations were developed using the best available evidence and graded according to the strength of that evidence. Topics to cover in the guideline were informed by an international survey of women and healthcare professionals. New information is provided about the genetic causes of POI, the impact of POI on muscle health, use of anti-mullerian hormone, non-hormonal therapies, lifestyle interventions and complementary therapies”.12

Early Menopause: Women’s Experiences

What is the (Australian) Healthtalk Australia’s Early Menopause: Women’s Experiences?

In Early Menopause: Women’s Experiences – Overview Healthtalk Australia elaborate on:

“On this unique site you can read, watch and listen to stories of 30 women aged between 28 and 51 years, from diverse socio-cultural backgrounds living in Victoria, Australia, who have shared what it is like to experience early menopause (EM).

Women talked about being diagnosed with spontaneous early menopause, premature ovarian insufficiency (POI), medically-induced early menopause, or menopausal symptoms as a result of cancer and/or other medical treatments”.13

Health Care Provider

What if I think I have POI?

If you think you have POI it may be in your best interest to choose to talk to your health care provider about this.

In Primary Ovarian Insufficiency: Symptoms – When To See A Doctor the Mayo Clinic elaborate on:

“If you’ve missed your period for three months or more, see your health care team to figure out the cause. You can miss your period for many reasons, such as pregnancy, stress, or a change in diet or exercise habits. But it’s best to get a health care checkup whenever your menstrual cycle changes.

Even if you don’t mind not having periods, see a health care professional to find out what’s causing the change. Low estrogen levels can lead to a condition that causes weak and brittle bones, called osteoporosis. Low levels of estrogen also can lead to heart disease”.14

Health Topics A-Z

Where may I find Health Topics A-Z related to Premature Ovarian Insufficiency?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

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Links

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New or Updated

  1. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  2. BMS TV: Premature Ovarian Insufficiency (POI)
  3. Bioidentical Hormones: Are They Safer?
  4. Bone Health In Women With Premature Ovarian Insufficiency/Early Menopause: A 23-Year Longitudinal Analysis
  5. Breast Cancer Is Increased In Women With Primary Ovarian Insufficiency
  6. CREWHiRL [Center for Research Excellence In Women’s Health In Reproductive Life]
  7. Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms
  8. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – Premature and Early Menopause
  9. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Cognitive Behavioral Therapy and Menopause
  10. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  11. Daisy Network
  12. Diagnostic Tests for Menopause
  13. EMAS On-Demand Webinars [European Menopause and Andropause Society] [Multiply Languages]: EMAS/ESE Webinar Part 1: Fertility In Late Reproductive Age [May 2024]
  14. ESHRE Guideline: Management of Women With Premature Ovarian Insufficiency
  15. Early Menopause Question Prompt List
  16. Early Menopause and POI Resources
  17. Early Menopause and POI Resources: What Is POI?
  18. Early Menopause and POI Resources: What’s New – 10 New Things About POI
  19. Early Menopause: Women’s Experiences – Overview
  20. Early Menopause: Women’s Experiences – Resources and Information: Quick Links – 1. Question Prompt List
  21. Evidence-Based Guideline: Premature Ovarian Insufficiency
  22. Find A Menopause Practitioner [United States and Other]
  23. Find An AMS Member [Australasian Menopause Society i.e. Australia and New Zealand]
  24. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  25. Follicle-Stimulating Hormone (FSH) Blood Test
  26. Follicle-Stimulating Hormone (FSH) Levels Test
  27. Fragile X and Premature Ovarian Insufficiency Webinar
  28. Fragile X-Associated Primary Ovarian Insufficiency (FXPOI): What Do I Need to Know?
  29. Premature Ovarian InsufficiencyGuideline on Premature Ovarian Insufficiency
  30. Guideline on Premature Ovarian Insufficiency (POI)
  31. Hot Flashes
  32. Hot Flashes: What Can I Do? [+ Video: What Are the Signs and Symptoms of Menopause?]
  33. International Monash Partnership Announced for Premature Ovarian Insufficiency Guidelines
  34. Is Premature Ovarian Insufficiency Associated With Mortality? A Three-Decade Follow-Up Cohort
  35. Landscape of Pathogenic Mutations In Premature Ovarian Insufficiency
  36. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Early and Premature Menopause [+ Video: Menopause Only Happens In Your 50s]
  37. Luteinizing Hormone (LH) Levels Test
  38. Mayo Clinic Minute: Help With Hot Flashes Due To Menopause [+ Video]
  39. Mayo Clinic Minute: How Lifestyle Changes May Help Manage Menopause Symptoms [+ Video]
  40. Menopause
  41. Menopause
  42. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Premature Ovarian Insufficiency
  43. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
    Premature Ovarian Insufficiency
  44. Menopause Mindfulness: Understanding the Many Paths To Menopause
  45. Menopause News 2024 What’s HotMenopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  46. Menopause Ruining Your Sex Life?
  47. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  48. Menopause and Mental Health
  49. Menopause: Identification and Management NICE Guideline Published: 12 November 2015 Last Updated: 07 November 2024
  50. Menopause: Identification and Management: NICE Guideline [NG23] Published: 12 November 2015 Last Updated: 07 November 2024
  51. Menopause: Information for Partners
  52. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  53. Menstrual Calendar
  54. N Z Early Menopause Support Group [New Zealand]
  55. National Center for Complementary and Integrative Health: Herbs At A Glance
  56. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  57. Navigating Menopause Together: How Partners Can Help
  58. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  59. New Guidelines Developed for the Diagnosis and Management of Premature Ovarian Insufficiency
  60. Nonhormone Treatments for Hot Flashes and Night Sweats
  61. Optimising Health After Early Menopause
  62. Premature Ovarian Insufficiency
  63. Premature Ovarian Insufficiency [BMS Consensus Statement [British Menopause Society]]
  64. Premature and Early Menopause
  65. Premature and Early Menopause
  66. Premature and Early Menopause
  67. Premature and Early Menopause: Managing Premature and Early Menopause
  68. Premature and Early Menopause: Symptoms of Premature and Early Menopause
  69. Premature and Early Menopause: What Causes Premature and Early Menopause? [+ Video]
  70. Primary Ovarian Insufficiency
  71. Primary Ovarian Insufficiency
  72. Primary Ovarian Insufficiency
  73. Premature Ovarian Insufficiency POI
  74. Primary Ovarian Insufficiency: A Toolkit for the Busy Clinician
  75. Premature Ovarian Insufficiency: Addressing the Most Controversial Issues
  76. Primary Ovarian Insufficiency: Diagnosis & Treatment – Coping and Support
  77. Primary Ovarian Insufficiency: Diagnosis & Treatment – Lifestyle and Home Remedies
  78. Primary Ovarian Insufficiency: Diagnosis & Treatment – Preparing For Your Appointment
  79. Primary Ovarian Insufficiency: Summary – How Is Primary Ovarian Insufficiency (POI) Diagnosed?
  80. Primary Ovarian Insufficiency: Summary – How Is Primary Ovarian Insufficiency (POI) Treated?
  81. Primary Ovarian Insufficiency: Summary – What Causes Primary Ovarian Insufficiency (POI)?
  82. Primary Ovarian Insufficiency: Symptoms & Causes – Causes [+ Video: Ovulation]
  83. Supporting A Loved One Through Menopause
  84. The Association Between Primary Ovarian Insufficiency and Increased Multimorbidity In A Large Prospective Cohort
  85. The Truth About Menopause Supplements | Dr Sarah Berry
  86. Tips To Help Manage Menopause Symptoms
  87. Turner Syndrome
  88. Turner Syndrome
  89. Understanding Fragile X
  90. Update of the 2015 Evidence Based Guideline on Premature Ovarian Insufficiency – Now Published [31 October 2024]
  91. Video: With Menstrual Irregularity, Consider Primary Ovarian Insufficiency
  92. Videos & Podcasts: Videos – Impending Menopause: How Can Fertility Be Preserved?
  93. Videos & Podcasts: Videos – Menopause and Hormone Therapy: Current Perspectives and Controversies
  94. Videos and Podcasts: Videos – Bone Health and Premature Ovarian Insufficiency
  95. Videos and Podcasts: Videos – When Your Periods Leave Too Early
  96. Webinars: Previous – Genetic Causes of POI
  97. Webinars: Previous – The New POI Guideline: What You Need To Know
  98. What You Need To Know About POI (Premature Ovarian Insufficiency) | Dr Louise Newson
  99. When Menopause Comes Early: Symptoms & Treatment
  100. World Menopause Day 2024: Leaflet for Women – Menopause and Menopause Hormone Therapy

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Panay, N., Anderson, R. A., Bennie, A., Cedars, M., Davies, M., … Vincent, A. J. (2024). Evidence-Based Guideline: Premature Ovarian Insufficiency. Published Online: 08 December 2024. Climacteric, 1–11 https://www.tandfonline.com/doi/full/10.1080/13697137.2024.2423213 Accessed: 26 April 2025
  2. Panay, N., Anderson, R. A., Bennie, A., Cedars, M., Davies, M., … Vincent, A. J. (2024). Evidence-Based Guideline: Premature Ovarian Insufficiency. Published Online: 08 December 2024:26. Climacteric, 1–11 https://www.tandfonline.com/doi/full/10.1080/13697137.2024.2423213 Accessed: 26 April 2025
  3. Primary Ovarian Insufficiency: Symptoms – When To See A Doctor. 20 October 2023. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683 Accessed: 26 April 2025
  4. Premature Ovarian Insufficiency: How Common Is Premature Ovarian Insufficiency. Last Reviewed: June 2024. You and Your Hormones, An Education Resource From the Society for Endocrinology https://www.yourhormones.info/endocrine-conditions/premature-ovarian-insufficiency/ Accessed: 26 April 2025
  5. Primary Ovarian Insufficiency: Summary – What Are the Symptoms of Primary Ovarian Insufficiency (POI)? Last Updated: 13 August 2024. MedlinePlus https://medlineplus.gov/primaryovarianinsufficiency.html Accessed: 26 April 2025
  6. Premature Ovarian Insufficiency: Summary of Recommendations. Reviewed: March 2024. British Menopause Society https://thebms.org.uk/publications/consensus-statements/premature-ovarian-insufficiency/ Accessed: 26 April 2025
  7. Menopause and Menopause Hormone Therapy: 2. Who Is MHT? 2024:2. International Menopause Society https://www.imsociety.org/wp-content/uploads/2024/10/2024-WMD-Leaflet_English.pdf Accessed: 26 April 2025
  8. Premature and Early Menopause: What Causes Premature and Early Menopause? How Does POI Affect Fertility? Last Updated: 24 April 2025. Last Reviewed: 22 April 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/premature-early-menopause Accessed: 26 April 2025
  9. Mishra, G. D. et al. Optimising Health After Early Menopause: Summary. 05 March 2024 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02800-3/fulltext Accessed: 26 April 2025
  10. Update of the 2015 Evidence Based Guideline on Premature Ovarian Insufficiency – Now Published. 31 October 2024. International Menopause Society https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Premature-ovarian-insufficiency Accessed: 26 April 2025
  11. ESHRE, ASRM, CREWHIRL and IMS Guideline Group on POI. Guideline on Premature Ovarian Insufficiency. https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Premature-ovarian-insufficiency Accessed: 26 April 2025
  12. International Monash Partnership Announced for Premature Ovarian Insufficiency Guidelines. 10 December 2024 https://www.monash.edu/news/articles/international-monash-partnership-announced-premature-ovarian-insufficiency-guidelines Accessed: 26 April 2025
  13. Early Menopause: Women’s Experiences – Overview. Healthtalk Australia https://healthtalkaustralia.org/early-menopause-experiences-and-perspectives-of-women-and-health-professionals/overview-womens-experiences/ Accessed: 26 April 2025
  14. Primary Ovarian Insufficiency: Symptoms – When To See A Doctor. 20 October 2023. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683 Accessed: 26 April 2025
Topic Last Updated: 18 May 2025 – Topic Last Reviewed: 26 April 2025

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