Premature Ovarian Insufficiency

“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:

  • 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. In Primary Ovarian Insufficiency: Symptoms & Causes – Overview the (United States) Mayo Clinic’s definition, dated 20 October 2023, is:

“Primary ovarian insufficiency occurs when the ovaries stop working as they should before age 40. When this happens, the ovaries don’t make the typical amounts of the hormone estrogen or release eggs regularly. The condition often leads to infertility. Another name for primary ovarian insufficiency is premature ovarian insufficiency. It also used to be called premature ovarian failure, but this term isn’t used anymore”.2

Premature Menopause

Is premature menopause the same as POI?

In Primary Ovarian Insufficiency: Symptoms & Causes – Overview the Mayo Clinic also 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 (less than 45 years) occurs in up to 12% of women”.4

POI and Periods

Can women with POI have periods?

In Menopause Before 40 and Spontaneous Premature Ovarian Insufficiency the Australasian Menopause Society (AMS) note:

“Women with spontaneous POI have irregular or no periods”.5

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”.6

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”.7

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”.8

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)”.9

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”.10

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”.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

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 (United States) 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”.13

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”.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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New or Updated

  1. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  2. BMS TV: Premature Ovarian Insufficiency (POI)
  3. Be A Force for Change. Know the Signs. Get Your Heart Checked.
  4. Bioidentical Hormones: Are They Safer?
  5. Bone Health In Women With Premature Ovarian Insufficiency/Early Menopause: A 23-Year Longitudinal Analysis
  6. Breast Cancer Is Increased In Women With Primary Ovarian Insufficiency
  7. Can Combined Oral Contraceptive Be Used As A Hormone Therapy In Women With Premature Ovarian Insufficiency? [Video]
  8. Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms
  9. Consumer Video and Podcast Series: 2022 Consumer Videos and Podcasts – Irregular Menstrual Cycles What’s Normal and What’s Abnormal?
  10. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – Premature and Early Menopause
  11. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  12. Daisy Network
  13. Diagnostic Tests for Menopause
  14. EMAS On-Demand Webinars [European Menopause and Andropause Society] [Multiply Languages]: EMAS/ESE Webinar Part 1: Fertility In Late Reproductive Age
  15. ESHRE Guideline: Management of Women With Premature Ovarian Insufficiency
  16. Early Menopause: Women’s Experiences – Overview
  17. Early Menopause: Women’s Experiences – Resources and Information: Quick Links – 1. Question Prompt List
  18. Find A Menopause Practitioner [United States and Other]
  19. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  20. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  21. Follicle-Stimulating Hormone (FSH) Blood Test
  22. Follicle-Stimulating Hormone (FSH) Levels Test
  23. Fragile X and Premature Ovarian Insufficiency Webinar
  24. Hormone Therapy: Is It Right for You?
  25. Hot Flashes
  26. Hot Flashes: What Can I Do? [+ Video: What Are the Signs and Symptoms of Menopause?]
  27. Menopause: Information for Partners
  28. Is Premature Ovarian Insufficiency Associated With Mortality? A Three-Decade Follow-Up Cohort
  29. Landscape of Pathogenic Mutations In Premature Ovarian Insufficiency
  30. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Early and Premature Menopause [+ Video: Menopause Only Happens In Your 50s]
  31. Luteinizing Hormone (LH) Levels Test
  32. Mayo Clinic Minute: Help With Hot Flashes Due To Menopause [+ Video]
  33. Mayo Clinic Minute: How Lifestyle Changes May Help Manage Menopause Symptoms [+ Video]
  34. Menopause
  35. Menopause Before 40 and Spontaneous Premature Ovarian Insufficiency
  36. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Premature Ovarian Insufficiency
  37. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
    Premature Ovarian Insufficiency
  38. Menopause Mindfulness: Understanding the Many Paths To Menopause
  39. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  40. Menopause Preparedness Toolkit Video Series: Treating Vasomotor Symptoms of Menopause
  41. Menopause Preparedness Toolkit Video Series: Understanding Menstrual Health and Menopause
  42. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  43. Menopause Ruining Your Sex Life?
  44. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  45. Menopause Treatments: What Works, What Doesn’t
  46. Menopause and Mental Health
  47. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  48. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  49. Menstrual Calendar
  50. Mood and the Menopause
  51. N Z Early Menopause Support Group [New Zealand]
  52. National Center for Complementary and Integrative Health: Herbs At A Glance
  53. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  54. Navigating Menopause Together: How Partners Can Help
  55. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  56. Non-Estrogen Treatments for Menopausal Symptoms
  57. Nonhormone Treatments for Hot Flashes and Night Sweats
  58. Optimising Health After Early Menopause
  59. Premature Ovarian Insufficiency
  60. Premature and Early Menopause
  61. Premature and Early Menopause
  62. Premature and Early Menopause
  63. Premature and Early Menopause: Managing Premature and Early Menopause
  64. Premature and Early Menopause: Symptoms of Premature and Early Menopause
  65. Premature and Early Menopause: What Causes Premature and Early Menopause? [+ Video]
  66. Primary Ovarian Insufficiency
  67. Primary Ovarian Insufficiency
  68. Primary Ovarian Insufficiency
  69. Primary Ovarian Insufficiency
  70. Primary Ovarian Insufficiency: A Toolkit for the Busy Clinician
  71. Primary Ovarian Insufficiency: Diagnosis & Treatment – Coping and Support
  72. Primary Ovarian Insufficiency: Diagnosis & Treatment – Lifestyle and Home Remedies
  73. Primary Ovarian Insufficiency: Diagnosis & Treatment – Preparing For Your Appointment
  74. Primary Ovarian Insufficiency: Questions To Ask Your Healthcare Provider
  75. Primary Ovarian Insufficiency: Summary – How Is Primary Ovarian Insufficiency (POI) Diagnosed?
  76. Primary Ovarian Insufficiency: Summary – How Is Primary Ovarian Insufficiency (POI) Treated?
  77. Primary Ovarian Insufficiency: Summary – What Causes Primary Ovarian Insufficiency (POI)?
  78. Primary Ovarian Insufficiency: Symptoms & Causes – Causes [+ Video: Ovulation]
  79. Spontaneous Premature Ovarian Insufficiency
  80. Supporting A Loved One Through Menopause
  81. The Association Between Primary Ovarian Insufficiency and Increased Multimorbidity In A Large Prospective Cohort
  82. The Lancet: Series From the Lancet Journals – Menopause 2024
  83. The Truth About Menopause Supplements | Dr Sarah Berry
  84. Tips To Help Manage Menopause Symptoms
  85. Turner Syndrome
  86. Turner Syndrome
  87. Understanding Fragile X
  88. Video: With Menstrual Irregularity, Consider Primary Ovarian Insufficiency
  89. Videos and Podcasts: Videos – Interviews: Bone Health and Premature Ovarian Insufficiency
  90. Videos & Podcasts: Videos – Interviews: Impending Menopause: How Can Fertility Be Preserved?
  91. Videos & Podcasts: Videos – Interviews: Preventing Bone Loss At Menopause
  92. Videos and Podcasts: Videos – Interviews: When Your Periods Leave Too Early
  93. Webinars: Previous – Genetic Causes of POI
  94. Webinars: Previous – POI: A New Era World Menopause Day Theme
  95. Webinars: Previous – Skin and Connective Tissue Ageing at the Time of the Menopause
  96. What Causes Menopause? Primary Ovarian Insufficiency (POI)
  97. What Is POI
  98. When Menopause Comes Early: Symptoms & Treatment
  99. Premature Ovarian InsufficiencyWorld Menopause Day 2020 – Patient Information Leaflet: Premature Ovarian Insufficiency (POI) [Multiply Languages]
  100. World Menopause Day 2024: Leaflet for Women

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

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: 01 August 2024
  2. 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: 01 August 2024
  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: 01 August 2024
  4. 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: 01 August 2024
  5. 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: 01 August 2024
  6. Premature and Early Menopause: What Causes Premature and Early Menopause? POI and Fertility. Last Updated: 05 July 2024. Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/premature-early-menopause Accessed: 01 August 2024
  7. 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: 01 August 2024
  8. Primary Ovarian Insufficiency: Summary – What Are the Symptoms of Primary Ovarian Insufficiency (POI)? Last Updated: 05 May 2021. MedlinePlus https://medlineplus.gov/primaryovarianinsufficiency.html Accessed: 01 August 2024
  9. 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: 01 August 2024
  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 2022:4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 01 August 2024
  11. 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: 01 August 2024
  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: 01 August 2024
  13. 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: 01 August 2024
  14. 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 Accessed: 01 August 2024
Topic Last Updated: 06 October 2024 – Topic Last Reviewed: 01 August 2024

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