“Loss of ovarian function occurring in women younger than 40 years of age is called premature ovarian insufficiency (POI). POI may also be referred to as…”.1

Umbrella

What may the Premature Ovarian Insufficiency (POI) Umbrella include?

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

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

Premature Menopause

Is premature menopause the same as premature ovarian insufficiency (POI)?

No. In Primary Ovarian Insufficiency: Symptoms & Causes – Overview the (United States) Mayo Clinic note:

“Primary ovarian insufficiency is sometimes confused with premature menopause, but these conditions aren’t the same. Women with primary ovarian insufficiency can have irregular or occasional periods for years and might even get pregnant. But women with premature menopause stop having periods and can’t become pregnant”.2

Premature Ovarian Insufficiency (POI)

What is premature ovarian insufficiency (POI)?

DotS the definition of POI may vary. In Spontaneous Premature Ovarian Insufficiency: Definitions and Epidemiology the Australasian Menopause Society (AMS) elaborate on:

“Loss of ovarian function occurring in women younger than 40 years of age is called premature ovarian insufficiency (POI). POI may also be referred to as primary ovarian insufficiency, premature menopause or premature/ primary ovarian failure)”.3

In Primary Ovarian Insufficiency: Symptoms & Causes – Overview the Mayo Clinic’s definition is:

“Primary ovarian insufficiency occurs when the ovaries stop functioning as they should before age 40. When this happens, your ovaries don’t produce typical amounts of the hormone estrogen or release eggs regularly. This condition is also called premature ovarian failure and often leads to infertility”.4

POI Common or Not

How common is POI?

In Premature Ovarian Insufficiency: How Common Is Premature Ovarian Insufficiency? You and Your Hormones, An Education Resource From 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 (less than 45 years) occurs in up to 12% of women”.5

POI and Periods

Can women with POI have periods?

In Menopause Before 40 and Spontaneous Premature Ovarian Insufficiency the AMS note:

“Women with spontaneous POI have irregular or no periods”.6

POI and Pregnancy

Can women with POI become pregnant?

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

“If you have been diagnosed with POI and do not want to become pregnant, you should use contraception. Many women are unable to conceive a baby naturally after POI; however, there is a one in 50 chance of a spontaneous pregnancy”.7

POI and Menopausal Symptoms

Can women with POI have menopausal symptoms?

In Menopause Before 40 and Spontaneous Premature Ovarian Insufficiency the AMS note:

“Women may or may not have menopausal symptoms such as hot flushes”.8

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”.9

Hormone Therapy

For women with POI, what is one of the recommendations about hormone therapy of the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause?

On page two in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published online 10 June 2022, one of the recommendations is:

“Women with POI and early menopause (40–45 years old) should be advised that HRT is unlikely to increase risk of breast cancer in younger menopausal women under the age of 50. The meta-analysis by the Collaborative Group on Hormonal Factors in Breast Cancer in 2019 reported that the use of HRT in postmenopausal women younger than 50 increases the risk of breast cancer diagnosis which contradicts previous evidence and advice to date. However, the control group, of age-matched postmenopausal women was inappropriate as an early menopause reduces breast cancer risk. Current recommendations are that the risk of breast cancer in relation to the years of HRT exposure in women with POI/early menopause should be counted from the average age of natural menopause (from the age 50 years)”.10

What is another recommendation of the Joint Position Statement?

On page four in the Joint Position Statement another recommendation is:

“Women with POI and early menopause (40–45 years old) should be advised to take hormone replacement at least until the average age of the menopause”.11

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”.12

World Menopause Day 2020Premature Ovarian Insufficiency

What was the theme for World Menopause Day 2020?

The theme for World Menopause Day 2020 was Premature Ovarian Insufficiency (POI).

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.

On page of two of the IMS’s Patient Information Leaflet: Premature Ovarian Insufficiency (POI)? Can POI Symptoms Be Successfully Treated? the IMS note:

“Yes! Symptoms can be successfully treated with hormone therapy and managed with a healthy diet, regular exercise and emotional well-being”.13

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

“If you’ve missed your period for three months or more, see your health care provider to determine the cause. You can miss your period for a number of reasons — including pregnancy, stress, or a change in diet or exercise habits — but it’s best to get evaluated whenever your menstrual cycle changes.

Even if you don’t mind not having periods, it’s advisable to see your provider to find out what’s causing the change. Low estrogen levels can lead to bone loss and an increased risk of heart disease”.14

In Primary Ovarian Insufficiency: Treatment & Therapies the Endocrine Society explain:

“Treatment depends on whether you have symptoms or are at risk for serious health problems. Hormone therapy (HT) is the most common treatment. HT combines estrogen and progesterone, another sex hormone. HT relieves menopausal symptoms and also helps prevent osteoporosis. HT can be taken as a pill or applied to your skin as a patch. Vaginal rings can also supply estrogen to the body”.15

Health Topics A-Z

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Sources

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Sources

  1. Spontaneous Premature Ovarian Insufficiency: Definitions and Epidemiology. Content Updated: September 2020. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/742-spontaneous-premature-ovarian-insufficiency Accessed: 25 November 2022
  2. Primary Ovarian Insufficiency: Symptoms – When To See A Doctor. 27 October 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683 Accessed: 25 November 2022
  3. Spontaneous Premature Ovarian Insufficiency: Definitions and Epidemiology. Content Updated: September 2020. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/742-spontaneous-premature-ovarian-insufficiency Accessed: 25 November 2022
  4. Primary Ovarian Insufficiency: Symptoms – When To See A Doctor. 27 October 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683 Accessed: 25 November 2022
  5. Premature Ovarian Insufficiency: How Common Is Premature Ovarian Insufficiency. Last Reviewed: April 2022. You and Your Hormones, An Education Resource From the Society for Endocrinology https://www.yourhormones.info/endocrine-conditions/premature-ovarian-insufficiency/ Accessed: 25 November 2022
  6. Menopause Before 40 and Spontaneous Premature Ovarian Insufficiency. Content Updated: October 2020. Australasian Menopause Society https://www.menopause.org.au/health-info/fact-sheets/menopause-before-40-and-spontaneous-poi Accessed: 25 November 2022
  7. Premature and Early Menopause: What Causes Premature and Early Menopause? POI and Fertility. Last Updated: 08 September 2022. Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/premature-early-menopause Accessed: 25 November 2022
  8. Menopause Before 40 and Spontaneous Premature Ovarian Insufficiency. Content Updated: October 2020. Australasian Menopause Society https://www.menopause.org.au/health-info/fact-sheets/menopause-before-40-and-spontaneous-poi Accessed: 25 November 2022
  9. Primary Ovarian Insufficiency: Summary – What Are the Symptoms of Primary Ovarian Insufficiency (POI)? Last Updated: 05 May 2022. MedlinePlus https://medlineplus.gov/primaryovarianinsufficiency.html Accessed: 25 November 2022
  10. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:2. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 25 November 2022
  11. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 25 November 2022
  12. 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: 25 November 2022
  13. Patient Information Leaflet: Premature Ovarian Insufficiency (POI). 2020:2. International Menopause Society https://www.imsociety.org/wp-content/uploads/2020/10/wmd-2020-leaflet-english.pdf Accessed: 25 November 2022
  14. Primary Ovarian Insufficiency: Symptoms – When To See A Doctor. 27 October 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683 Accessed: 25 November 2022
  15. Primary Ovarian Insufficiency: How Is POI Treated? Last Updated: 24 January 2022. Endocrine Society https://www.endocrine.org/patient-engagement/endocrine-library/primary-ovarian-insuffiency 25 November 2022
Topic Last Updated: 25 November 2022 – Topic Last Reviewed: 25 November 2022

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