Premature Ovarian Insufficiency

Premature ovarian insufficiency (POI) refers to menopause or symptoms of oestrogen deficiency under the age of 40. It has a prevalence of 1%. Genetic factors, autoimmune factors, infections, and iatrogenic causes such as chemotherapy, radiotherapy, and surgery are reasons why women might have POI. However, in most cases no cause is identified.

The long-term complications of untreated POI have been documented in the literature. These include reduced bone mineral density with resultant increased risk of developing osteoporosis and fractures, an increased risk of cardiovascular disease, increased risk of Parkinson’s Disease, reduced cognition, and decreased life expectancy.

Menopausal hormone therapy has a beneficial role in maintaining bone and cardiovascular health in addition to symptom control, and has been approved by the NICE guidelines as the treatment of choice for women with POI without a contraindication to its use. Research suggests that most women with POI who take MHT up until the average age of natural menopause are at no increased risk of breast cancer above that of their baseline genetic risk.

It is essential that women with POI get access to the most up-to-date, evidence-based treatment and appropriate psychological support.