Materiały źródłowe

• #1 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years).

• #2 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #3

  https://journals.lww.com/greenjournal/fulltext/2017/05000/committee_opinion_no__698__hormone_therapy_in.48.aspx

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years). […] The approach to HT for primary ovarian insufficiency is full replacement doses of hormone for long-term treatment.

• #4 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years).

• #5 Committee Opinion No. 698: Hormone Therapy in Primary Ovarian Insufficiency – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28426619/

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 50-51 years). […] Finally, considering the challenges that adolescents and young women may face in coping with the physical, reproductive, and social effects of primary ovarian insufficiency, comprehensive longitudinal management of this condition is essential.

• #6 Primary Ovarian Insufficiency | POI | MedlinePlus

  https://medlineplus.gov/primaryovarianinsufficiency.html

  Currently, there is no proven treatment to restore normal function to a woman’s ovaries. But there are treatments for some of the symptoms of POI. There are also ways to lower your health risks and treat the conditions that POI can cause: […] Hormone replacement therapy (HRT). HRT is the most common treatment. It gives your body the estrogen and other hormones that your ovaries are not making. HRT improves sexual health and decreases the risks for heart disease and osteoporosis. You usually take it until about age 50; that’s about the age when menopause usually begins. […] In vitro fertilization (IVF). If you have POI and you wish to become pregnant, you may consider trying IVF. […] Treatments for associated conditions. If you have a condition that is related to POI, it is important to treat that as well. Treatments may involve medicines and hormones.

• #7 Primary ovarian insufficiency – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/diagnosis-treatment/drc-20354688

  Most often, treatment for primary ovarian insufficiency focuses on the problems that arise from estrogen deficiency. Treatment might include: […] Estrogen therapy can help prevent osteoporosis. It also can relieve hot flashes and other symptoms of low estrogen. You’ll likely be prescribed estrogen with the hormone progesterone if you still have your uterus. Adding progesterone protects the lining of your uterus, called the endometrium, from changes that could lead to cancer. These changes may be caused by taking estrogen alone. […] In older women, long-term estrogen plus progesterone treatment has been linked to a higher risk of heart and blood vessel disease and breast cancer. In young people with primary ovarian insufficiency, the benefits of hormone therapy outweigh the risks. […] Calcium and vitamin D supplements. Both nutrients are key for preventing osteoporosis. And you might not get enough of either in your diet or from sunlight.

• #8 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years).

• #9 What are the treatments for POI? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/poi/conditioninfo/treatments

  Currently, there is no proven treatment to restore normal function to a woman’s ovaries. But there are treatments for some of the symptoms of POI, as well as treatments and behaviors to reduce health risks and conditions associated with POI. […] HRT is the most common treatment for women with POI. It gives the body the estrogen and other hormones that the ovaries are not making. HRT improves sexual health and decreases the risks for cardiovascular disease (including heart attacks, stroke, and high blood pressure) and osteoporosis. […] If a woman with POI begins HRT, she is expected to start having regular periods again. In addition, HRT is expected to reduce other symptoms, such as hot flashes and night sweats, and help maintain bone health. […] HRT will not prevent pregnancy, and evidence suggests it might improve pregnancy rates for women with POI by lowering high levels of luteinizing hormone which stimulates ovulation to normal in some women.

• #10 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  In contrast to the treatment of postmenopausal osteopenia or osteoporosis, which focuses on bisphosphonates as first-line therapy, low bone mass in women with primary ovarian insufficiency is managed most appropriately with HT. […] Women with primary ovarian insufficiency may experience hot flushes, night sweats, vaginal dryness, dyspareunia, and disordered sleep; some symptoms may develop before cycle irregularity. These symptoms routinely respond well to HT as indicated. […] Combined hormonal contraceptives prevent ovulation and pregnancy more reliably than HT; despite only modest odds of spontaneous pregnancy in women with primary ovarian insufficiency, this is a critical consideration for those who deem pregnancy prevention a priority. […] The approach to HT for primary ovarian insufficiency is full replacement doses of hormone for long-term treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency.

• #11 SciELO Brazil – Premature ovarian insufficiency: A hormonal treatment approach Premature ovarian insufficiency: A hormonal treatment approach

  https://www.scielo.br/j/rbgo/a/vwxj4zQhW3cQXVrgvcZZW6q/?lang=en

  Premature ovarian insufficiency (POI) is characterized by loss of ovarian function before the age of 40 years. […] Hormonal treatment is mandatory for all POI-women with no contraindication, and it shall be continued until the usual age of menopause. […] Unless contraindicated, the formal recommendation is estrogen replacement therapy with menacme-adjusted doses to improve vasomotor and genitourinary symptoms, maintain bone health, prevent osteoporosis and reduce the risk of fractures, administered until the physiological age of menopause. […] The objectives of POI treatment are symptoms relief and reducing the repercussions of hypoestrogenism. […] Estrogen replacement is recommended to maintain bone health, prevent osteoporosis, and reduce the risk of fracture. […] HRT shall be prescribed to endometriosis patients presenting with POI secondary to oophorectomy. Continuous estroprogestative therapy is recommended, even if the patient is hysterectomized. […] HRT is recommended to be continued until the usual age of menopause, i.e., around 50 years of age.

• #12 What are the treatments for POI? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/poi/conditioninfo/treatments

  Currently, there is no proven treatment to restore normal function to a woman’s ovaries. But there are treatments for some of the symptoms of POI, as well as treatments and behaviors to reduce health risks and conditions associated with POI. […] HRT is the most common treatment for women with POI. It gives the body the estrogen and other hormones that the ovaries are not making. HRT improves sexual health and decreases the risks for cardiovascular disease (including heart attacks, stroke, and high blood pressure) and osteoporosis. […] If a woman with POI begins HRT, she is expected to start having regular periods again. In addition, HRT is expected to reduce other symptoms, such as hot flashes and night sweats, and help maintain bone health. […] HRT will not prevent pregnancy, and evidence suggests it might improve pregnancy rates for women with POI by lowering high levels of luteinizing hormone which stimulates ovulation to normal in some women.

• #13 FXPOI Treatment Recommendations

  https://fragilex.org/professional-resources/treatment-recommendations/fragile-x-associated-primary-ovarian-insufficiency/

  As noted above, in interviews with women carrying a premutation, revealed that a proportion of women, and in some cases their physicians, did not appreciate the importance of HRT in young women with POI. […] Each woman should openly voice her questions or concerns about HRT and discuss alternatives and risks with her physician to identify her best option for care. […] Physiologic HRT has the advantage of lowering serum luteinizing hormone levels to normal in women with POI, which theoretically could improve their chance of normal follicle growth and subsequent ovulation.

• #14

  https://bpac.org.nz/2019/ovarian.aspx

  Higher doses of MHT are recommended for women with primary ovarian insufficiency than women of menopausal age as the treatment goal is to achieve hormone levels in the pre-menopausal range. […] Various treatment options are available to manage primary ovarian insufficiency: High dose menopausal hormone therapy (MHT) […] A COC; for further information see: www.bpac.org.nz/2019/contraception/oral-contraceptives.aspx […] Currently, there is no conclusive evidence regarding the optimal hormone treatment regimen. Treatment selection should be individualised to improve adherence, taking into account any relevant history, contraindications to MHT or COC use, co-morbidities, need for contraception and patient preference. […] Women with primary ovarian insufficiency should be reviewed at least annually, including an assessment of symptom control, adherence to treatment and cardiovascular risk.

• #15 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years).

• #16 Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/03-2021/different-approaches-to-hormone-replacement-therapy-in-women-with-premature-ovarian-insufficiency/

  The International Menopause Society (IMS) proposes adapting estradiol doses to achieve physiological levels of estradiol in a target range of 200-400 pmol/l. […] If the uterus is intact, administration of a progesterone is essential for endometrial protection. Endometrial protection is strongly recommended by all authors of recent publications, but there is wide range in terms of proposed dosages, time spans and compounds. […] The current IMS white paper recommends a higher dose of estrogen than is intended for natural menopausal therapy. The goal of therapy should be to achieve physiologic estradiol levels of between 200 and 400 pmol/l. […] Patients with POI benefit greatly from HRT. An HRT regimen that mimics natural ovarian hormone production and achieves physiologic estrogen levels should be chosen until the age of natural menopause.

• #17 Premature ovarian insufficiency – British Menopause Society

  https://thebms.org.uk/publications/consensus-statements/premature-ovarian-insufficiency/

  Premature ovarian insufficiency […] Systemic sex steroid hormone replacement is effective for the management of menopausal symptoms in women with POI and topical estrogen preparations are effective for the management of symptoms related to urogenital atrophy. […] Women with POI should be advised to take hormone replacement and continue to do so until the natural age of the menopause in the absence of a contra-indication to minimise this risk. The aim of hormone replacement in women with POI should be to achieve physiological levels of estradiol. […] There is limited evidence assessing the optimal regimen, dose or route of administration of hormone replacement in women with POI. HRT and the combined oral contraceptive pill containing ethinyl estradiol would both be suitable options for hormone replacement, although HRT may be more beneficial in improving bone health and cardiovascular markers compared to the combined oral contraceptive pill. […] Sex steroid hormone replacement should be considered the preferred choice of treatment for the prevention and management of osteoporosis in women with POI. […] Further research is required to assess the optimal regimen, dose or route of administration of hormone replacement in women with POI.

• #18 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  In contrast to the treatment of postmenopausal osteopenia or osteoporosis, which focuses on bisphosphonates as first-line therapy, low bone mass in women with primary ovarian insufficiency is managed most appropriately with HT. […] Women with primary ovarian insufficiency may experience hot flushes, night sweats, vaginal dryness, dyspareunia, and disordered sleep; some symptoms may develop before cycle irregularity. These symptoms routinely respond well to HT as indicated. […] Combined hormonal contraceptives prevent ovulation and pregnancy more reliably than HT; despite only modest odds of spontaneous pregnancy in women with primary ovarian insufficiency, this is a critical consideration for those who deem pregnancy prevention a priority. […] The approach to HT for primary ovarian insufficiency is full replacement doses of hormone for long-term treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency.

• #19 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Hormone therapy gives your body the hormones that your ovaries aren’t making. Hormone therapy may involve taking just estrogen or taking estrogen and progesterone. Hormone therapy can help reduce symptoms of POI like night sweats and vaginal dryness. It will also lower your risk for osteoporosis and other conditions that POI can cause. Your provider may prescribe hormone therapy in different ways, such as a pill, cream, gel, patch or vaginal ring. […] If you begin HRT, you’ll continue treatment up until the age when natural menopause typically begins (age 51 to 52). Discuss the benefits and risks of HRT with your provider to make sure it’s right for you. […] In addition to HRT, other treatments could include: taking calcium and vitamin D to help lower your risk of osteoporosis; getting regular physical exercise, lifting weights (for your bone health) and maintaining a healthy weight; exploring options for fertility treatment if you wish to expand your family.

• #20 Ovarian Insufficiency Treatment & Management: Medical Care, Further Outpatient Care, Consultations

  https://emedicine.medscape.com/article/271046-treatment

  Medical treatment of patients with POI/POF should address the following aspects: ovarian hormone replacement, restoration of fertility, and psychological well-being of the patient. […] The ovary is not only a reproductive organ but is also a source of important hormones that help maintain strong bones. Adequate replacement of these missing hormones, a healthy lifestyle, and a diet rich in calcium are essential. […] All women with POI/POF should receive cyclical HT with estrogens and progestins to relieve the symptoms of estrogen deficiency and to maintain bone density. […] Estrogens can be administered orally or transdermally. […] Progestins should be administered cyclically, 10-14 days each month, to prevent endometrial hyperplasia that unopposed estrogen may cause. […] Androgen replacement could be carefully considered for women who have persistent fatigue, low libido, and poor well being despite adequate estrogen replacement and when depression has been ruled out or adequately treated. […] No intervention has been proven to increase the ovulation rate or restore fertility in patients with POI/POF. […] Patients with POI/POF can have successful pregnancy with a donor egg. A decision to proceed with such a procedure should be made after a fair discussion of different options.

• #21 Primary ovarian insufficiency – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/diagnosis-treatment/drc-20354688

  Most often, treatment for primary ovarian insufficiency focuses on the problems that arise from estrogen deficiency. Treatment might include: […] Estrogen therapy can help prevent osteoporosis. It also can relieve hot flashes and other symptoms of low estrogen. You’ll likely be prescribed estrogen with the hormone progesterone if you still have your uterus. Adding progesterone protects the lining of your uterus, called the endometrium, from changes that could lead to cancer. These changes may be caused by taking estrogen alone. […] In older women, long-term estrogen plus progesterone treatment has been linked to a higher risk of heart and blood vessel disease and breast cancer. In young people with primary ovarian insufficiency, the benefits of hormone therapy outweigh the risks. […] Calcium and vitamin D supplements. Both nutrients are key for preventing osteoporosis. And you might not get enough of either in your diet or from sunlight.

• #22 Reddit – The heart of the internet

  https://www.reddit.com/r/POFlife/comments/dy9ovc/pof_treatment_a_basic_primer/

  This is meant to be a basic introduction to treatment recommendations. […] POF should absolutely be treated with very rare exception. Treatment should not be delayed unless there is a clear medical reason not to treat. […] Hormone therapy is an effective treatment for all of these complications of low estrogen and decreases these long term health complications, and also improves mental health and quality of life. Because of this it is recommended that all women with POI receive hormone therapy until the average age of natural menopause, 51. […] First line (gold standard) treatment is estrogen supplementation via pills or patches. Progesterone therapy is also recommended if you have a uterus because estrogen alone can lead to overgrowth of the uterine lining, which is a risk for endometrial cancer.

• #23 Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/03-2021/different-approaches-to-hormone-replacement-therapy-in-women-with-premature-ovarian-insufficiency/

  The International Menopause Society (IMS) proposes adapting estradiol doses to achieve physiological levels of estradiol in a target range of 200-400 pmol/l. […] If the uterus is intact, administration of a progesterone is essential for endometrial protection. Endometrial protection is strongly recommended by all authors of recent publications, but there is wide range in terms of proposed dosages, time spans and compounds. […] The current IMS white paper recommends a higher dose of estrogen than is intended for natural menopausal therapy. The goal of therapy should be to achieve physiologic estradiol levels of between 200 and 400 pmol/l. […] Patients with POI benefit greatly from HRT. An HRT regimen that mimics natural ovarian hormone production and achieves physiologic estrogen levels should be chosen until the age of natural menopause.

• #24

  https://bpac.org.nz/2019/ovarian.aspx

  Higher doses of MHT are recommended for women with primary ovarian insufficiency than women of menopausal age as the treatment goal is to achieve hormone levels in the pre-menopausal range. […] Various treatment options are available to manage primary ovarian insufficiency: High dose menopausal hormone therapy (MHT) […] A COC; for further information see: www.bpac.org.nz/2019/contraception/oral-contraceptives.aspx […] Currently, there is no conclusive evidence regarding the optimal hormone treatment regimen. Treatment selection should be individualised to improve adherence, taking into account any relevant history, contraindications to MHT or COC use, co-morbidities, need for contraception and patient preference. […] Women with primary ovarian insufficiency should be reviewed at least annually, including an assessment of symptom control, adherence to treatment and cardiovascular risk.

• #25 Reddit – The heart of the internet

  https://www.reddit.com/r/POFlife/comments/dy9ovc/pof_treatment_a_basic_primer/

  Continuous recommendation: 1-2mg oral estradiol (estrogen) daily with 2.5-5mg medroxyprogesterone (progesterone) pill daily or 100 mcg per day estradiol patch with 100mg micronized progesterone pill daily. […] In addition vaginal estrogen cream is recommended on top of the above for persisting symptoms of vaginal dryness, irritation, or urine leakage. […] Testosterone therapy or DHEA (which is related) is controversially recommended in women with low testosterone levels who have symptoms such as low libido. […] Treatment of POF is under researched, so a lot of these treatment guidelines are a combination of medical research and clinical experience from trial and error.

• #26 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  Hormone therapy (HT) can mitigate some of these effects, many questions still remain regarding the optimal management of POI. […] The guideline describes different management options, but it must be acknowledged that for most of these options, supporting evidence is limited for POI. […] The guideline provides health care professionals with clear advice on best practice in POI care, based on the best evidence currently available. […] The information on treatment indications is included in a chapter on hormone therapy (HT), which also covers further topics related to risks and options for HT in general and in women with POI, and comorbidities where data exist. […] The guideline group recommends that the dose of progestogen is increased when higher doses of estrogen therapy are used. […] The guideline group recommends that women with POI should be encouraged to adopt a healthy lifestyle (including weight-bearing exercise, healthy diet, avoiding smoking, and maintaining normal body weight) to optimise bone health.

• #27 Ovarian Insufficiency Treatment & Management: Medical Care, Further Outpatient Care, Consultations

  https://emedicine.medscape.com/article/271046-treatment

  Medical treatment of patients with POI/POF should address the following aspects: ovarian hormone replacement, restoration of fertility, and psychological well-being of the patient. […] The ovary is not only a reproductive organ but is also a source of important hormones that help maintain strong bones. Adequate replacement of these missing hormones, a healthy lifestyle, and a diet rich in calcium are essential. […] All women with POI/POF should receive cyclical HT with estrogens and progestins to relieve the symptoms of estrogen deficiency and to maintain bone density. […] Estrogens can be administered orally or transdermally. […] Progestins should be administered cyclically, 10-14 days each month, to prevent endometrial hyperplasia that unopposed estrogen may cause. […] Androgen replacement could be carefully considered for women who have persistent fatigue, low libido, and poor well being despite adequate estrogen replacement and when depression has been ruled out or adequately treated. […] No intervention has been proven to increase the ovulation rate or restore fertility in patients with POI/POF. […] Patients with POI/POF can have successful pregnancy with a donor egg. A decision to proceed with such a procedure should be made after a fair discussion of different options.

• #28 Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/03-2021/different-approaches-to-hormone-replacement-therapy-in-women-with-premature-ovarian-insufficiency/

  Premature ovarian insufficiency (POI) is a major burden in the lives of affected women, many of whom are still very young. […] This article summarizes the current recommendations on hormonal treatment of POI, discusses pros and cons of the various hormone preparations, sets out the beneficial effects of the different estrogen and progesterone preparations, and draws attention to possible disadvantages of certain preparations. […] Systemic hormone replacement is necessary to reduce these symptoms. Furthermore, if local symptoms such as vaginal atrophy and dyspareunia are present, additional topical estrogen administration may be indicated. […] HRT is recommended in POI to control symptoms and prevent subsequent consequences of ovarian hormone insufficiency. The term hormone replacement therapy is highly appropriate, as the hormones used replace what would be present physiologically.

• #29 Reddit – The heart of the internet

  https://www.reddit.com/r/POFlife/comments/dy9ovc/pof_treatment_a_basic_primer/

  Continuous recommendation: 1-2mg oral estradiol (estrogen) daily with 2.5-5mg medroxyprogesterone (progesterone) pill daily or 100 mcg per day estradiol patch with 100mg micronized progesterone pill daily. […] In addition vaginal estrogen cream is recommended on top of the above for persisting symptoms of vaginal dryness, irritation, or urine leakage. […] Testosterone therapy or DHEA (which is related) is controversially recommended in women with low testosterone levels who have symptoms such as low libido. […] Treatment of POF is under researched, so a lot of these treatment guidelines are a combination of medical research and clinical experience from trial and error.

• #30 Primary ovarian insufficiency – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/diagnosis-treatment/drc-20354688

  No treatment is proven to restore fertility. But some people with primary ovarian insufficiency and their partners try to become pregnant through a procedure called in vitro fertilization. The procedure involves removing eggs from a donor and fertilizing them with sperm. A fertilized egg, called an embryo, is then placed in the uterus.

• #31 What are the treatments for POI? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/poi/conditioninfo/treatments

  Currently, there is no proven treatment to restore normal function to a woman’s ovaries. But there are treatments for some of the symptoms of POI, as well as treatments and behaviors to reduce health risks and conditions associated with POI. […] HRT is the most common treatment for women with POI. It gives the body the estrogen and other hormones that the ovaries are not making. HRT improves sexual health and decreases the risks for cardiovascular disease (including heart attacks, stroke, and high blood pressure) and osteoporosis. […] If a woman with POI begins HRT, she is expected to start having regular periods again. In addition, HRT is expected to reduce other symptoms, such as hot flashes and night sweats, and help maintain bone health. […] HRT will not prevent pregnancy, and evidence suggests it might improve pregnancy rates for women with POI by lowering high levels of luteinizing hormone which stimulates ovulation to normal in some women.

• #32 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  No, primary ovarian insufficiency isn’t reversible. Healthcare providers can treat symptoms, side effects and associated conditions, but they can’t cure it. […] About 25% of women with POI may experience ovulation at least once even after diagnosis. However, there isn’t treatment that can make your ovaries start to work again. Treatment for primary ovarian insufficiency helps relieve symptoms of the condition and lowers your risk of health conditions that POI may cause.

• #33 Primary ovarian insufficiency – Wikipedia

  https://en.wikipedia.org/wiki/Primary_ovarian_insufficiency

  Treatment will vary depending on the symptoms. It can include hormone replacement therapy, fertility management, and psychosocial support, as well as annual screenings of thyroid and adrenal function. […] Between 5 and 10% of women with POI may become pregnant with no treatment. […] As of 2016, no fertility treatment has been found to effectively increase fertility in women with POI, and the use of donor eggs with in-vitro fertilization (IVF) and adoption are a means of achieving parenthood for women with POI. […] Researchers have investigated the use of a hormone called dehydroepiandrosterone (DHEA) in women with POI to increase spontaneous pregnancy rates. […] In 2013, Kawamura in Japan and his collaborators at Stanford University published treatment of infertility of POI patients by fragmenting ovaries followed by in vitro treatment of ovarian fragments with phosphatidylinositol-3 kinase activators to enhance the AKT pathway followed by autografting.

• #34 Primary ovarian insufficiency- An overview: Part 2 diagnosis and management – IJOGR

  https://www.ijogr.org/html-article/20328

  Women with primary ovarian insufficiency might benefit from hormone replacement treatment since it can lessen their chances of developing osteoporosis, cardiovascular disease, and urogenital atrophy and increase their overall quality of life. […] The key recommendations by the American College of Obstetricians and K 9.7 […] HRT should be continued at least until the age of natural menopause, or around 50 years old and Subsequently recommendations for HRT in naturally menopausal women should be followed. […] Primary ovarian insufficiency is treated until the typical age of natural menopause is achieved, which is between the ages of 50 and 51 for most women. […] The possibility for spontaneous conception is up to 5% in women with POI and thus women who don’t wish to become pregnant are better to use contraception.

• #35 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #36 Ovarian Insufficiency Treatment & Management: Medical Care, Further Outpatient Care, Consultations

  https://emedicine.medscape.com/article/271046-treatment

  Medical treatment of patients with POI/POF should address the following aspects: ovarian hormone replacement, restoration of fertility, and psychological well-being of the patient. […] The ovary is not only a reproductive organ but is also a source of important hormones that help maintain strong bones. Adequate replacement of these missing hormones, a healthy lifestyle, and a diet rich in calcium are essential. […] All women with POI/POF should receive cyclical HT with estrogens and progestins to relieve the symptoms of estrogen deficiency and to maintain bone density. […] Estrogens can be administered orally or transdermally. […] Progestins should be administered cyclically, 10-14 days each month, to prevent endometrial hyperplasia that unopposed estrogen may cause. […] Androgen replacement could be carefully considered for women who have persistent fatigue, low libido, and poor well being despite adequate estrogen replacement and when depression has been ruled out or adequately treated. […] No intervention has been proven to increase the ovulation rate or restore fertility in patients with POI/POF. […] Patients with POI/POF can have successful pregnancy with a donor egg. A decision to proceed with such a procedure should be made after a fair discussion of different options.

• #37 Primary Ovarian Insufficiency – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/primary-ovarian-insufficiency

  Other options for women who desire pregnancy include cryopreservation of ovarian tissue, oocytes, or embryos and embryo donation. […] Unless contraindicated, hormonal therapy or estrogen/progestin contraceptives are recommended rather than other bone-specific treatments (eg, bisphosphonates) to prevent bone loss in women with premature ovarian insufficiency; these treatments are given until women reach the average age for menopause (about age 51), when treatment may be reassessed. […] To help prevent osteoporosis, women with primary ovarian insufficiency should consume an adequate amount of calcium and vitamin D (in the diet and/or as supplements).

• #38 Primary Ovarian Insufficiency – Symptoms, Causes, Diagnosis and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/primary-ovarian-insufficiency

  As stated previously, under 10 percent of individuals with POI are able to conceive and give birth naturally without additional therapy. There is no evidence that estrogen, fertility medications, or other hormones boost fertility. Successful treatments include in vitro fertilization (IVF) utilizing donor eggs. Before you begin attempting to conceive, you should consult with your healthcare practitioner to determine the cause of your issue. If a pregnancy is successful, various underlying causes of POI may create issues with the pregnancy or fetus. In certain circumstances, adoption is a viable alternative.

• #39 What are the treatments for POI? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/poi/conditioninfo/treatments

  Currently, there is no proven treatment to restore normal function to a woman’s ovaries. But there are treatments for some of the symptoms of POI, as well as treatments and behaviors to reduce health risks and conditions associated with POI. […] HRT is the most common treatment for women with POI. It gives the body the estrogen and other hormones that the ovaries are not making. HRT improves sexual health and decreases the risks for cardiovascular disease (including heart attacks, stroke, and high blood pressure) and osteoporosis. […] If a woman with POI begins HRT, she is expected to start having regular periods again. In addition, HRT is expected to reduce other symptoms, such as hot flashes and night sweats, and help maintain bone health. […] HRT will not prevent pregnancy, and evidence suggests it might improve pregnancy rates for women with POI by lowering high levels of luteinizing hormone which stimulates ovulation to normal in some women.

• #40 FXPOI Treatment Recommendations

  https://fragilex.org/professional-resources/treatment-recommendations/fragile-x-associated-primary-ovarian-insufficiency/

  As noted above, in interviews with women carrying a premutation, revealed that a proportion of women, and in some cases their physicians, did not appreciate the importance of HRT in young women with POI. […] Each woman should openly voice her questions or concerns about HRT and discuss alternatives and risks with her physician to identify her best option for care. […] Physiologic HRT has the advantage of lowering serum luteinizing hormone levels to normal in women with POI, which theoretically could improve their chance of normal follicle growth and subsequent ovulation.

• #41 Therapeutic options for premature ovarian insufficiency: an updated review | Reproductive Biology and Endocrinology | Full Text

  https://rbej.biomedcentral.com/articles/10.1186/s12958-022-00892-8

  Primary ovarian insufficiency (POI) is a rare gynecological condition. Historically, hormone replacement therapy is the first-line treatment for this disorder. Women diagnosed with POI are left with limited therapeutic options. In order to remedy this situation, a new generation of therapeutic approaches, such as in vitro activation, mitochondrial activation technique, stem cell and exosomes therapy, biomaterials strategies, and platelet-rich plasma intra-ovarian infusion, is being developed. However, these emerging therapies are yet in the experimental stage and require precise design components to accelerate their conversion into clinical treatments. Thus, each medical practitioner bears responsibility for selecting suitable therapies for individual patients. […] POI may be treated in one of several ways. Hormone replacement therapy (HRT) should be regarded as a physiological replacement of estrogens (+ progestin), but it fails to restore ovarian function. Currently used novel strategies mainly include in vitro activation (IVA), mitochondrial activation, stem cell and exosomes therapy, biomaterials strategies and intra-ovarian infusion of platelet-rich plasma (PRP). However, these new therapies, which are expected to be breakthrough therapies for POI, are still in their experimental stages, and their efficacy and safety must be proven prior to acceptance as true clinical options. This review summarizes current and future therapeutic strategies for POI.

• #42 Primary ovarian insufficiency- An overview: Part 2 diagnosis and management – IJOGR

  https://www.ijogr.org/html-article/20328

  Women with POI tend to have weaker bones as evident by decrease bone mineral density (BMD) and are more likely to have a fracture as they age because of hypoestrogenism. […] To keep their bones healthy and avoid osteoporosis, it is suggested that women take oestrogen replacement therapy in addition to consuming between 0.5 and 1.0 g of calcium and 400 to 800 IU of vitamin D daily, or a combination of the two. […] Hormone replacement therapy with early initiation is highly recommended in women with POI as it has beneficial effects on plasma lipids, blood pressure, insulin resistance, and endothelial function and also may reduce metabolic syndrome. […] Primary ovarian insufficiency (POI) treatment has the potential to be dramatically improved by new and upcoming medicines.

• #43 Therapeutic options for premature ovarian insufficiency: an updated review | Reproductive Biology and Endocrinology | Full Text

  https://rbej.biomedcentral.com/articles/10.1186/s12958-022-00892-8

  Several treatments of premature ovarian failure. For POI patients, HRT is the first-line treatment. In vitro activation, mitochondrial activation technique, stem cell and exosomes therapy, biomaterials strategies, and platelet-rich plasma intra-ovarian infusion are a new generation of treatments for POI management. […] IVA has been successfully applied in clinical practice. Conventional IVA in POI patients was the combination of PTEN inhibitors and PI3K activators, followed by ovarian fragmentation and autografting cortical strips via laparoscopic surgery. This procedure resulted in two pregnancies and one healthy delivery. […] Drug-free IVA was developed more recently. It focuses only on disrupting the Hippo pathway and avoids chemical activation of ovaries. A growing number of studies have reported that drug-free IVA had led to successful pregnancies.

• #44 Model construction and drug therapy of primary ovarian insufficiency by ultrasound-guided injection | Stem Cell Research & Therapy | Full Text

  https://stemcellres.biomedcentral.com/articles/10.1186/s13287-024-03646-y

  Ultrasound-guided hUC-MSC exosome injection was performed by a skilled sonographer. […] The results showed that hUC-MSC exosome can effectively rescue the hormone imbalances. […] Our results showed that the reproductive function of POI rat from hUC-MSC exosomes therapy was significantly improved, which collectively suggested that hUC-MSC exosomes showed therapeutic effects on POI rats. […] In conclusion, our data propose a novel strategy based on hUC-MSC exosomes may be applied to the treatment of POI disease in the future.

• #45 Therapeutic options for premature ovarian insufficiency: an updated review | Reproductive Biology and Endocrinology | Full Text

  https://rbej.biomedcentral.com/articles/10.1186/s12958-022-00892-8

  Stem cell therapy is expected to restore ovarian function and fertility for POI patients. […] Although current studies support the development of IVA, this technique is still in its formative stage. […] PRP may be considered as a putative alternative strategy for treating POI. […] The next logical step would be the careful implementation of precisely designed, large scale, randomized clinical trials.

• #46 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #47 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  In contrast to the treatment of postmenopausal osteopenia or osteoporosis, which focuses on bisphosphonates as first-line therapy, low bone mass in women with primary ovarian insufficiency is managed most appropriately with HT. […] Women with primary ovarian insufficiency may experience hot flushes, night sweats, vaginal dryness, dyspareunia, and disordered sleep; some symptoms may develop before cycle irregularity. These symptoms routinely respond well to HT as indicated. […] Combined hormonal contraceptives prevent ovulation and pregnancy more reliably than HT; despite only modest odds of spontaneous pregnancy in women with primary ovarian insufficiency, this is a critical consideration for those who deem pregnancy prevention a priority. […] The approach to HT for primary ovarian insufficiency is full replacement doses of hormone for long-term treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency.

• #48 Primary ovarian insufficiency- An overview: Part 2 diagnosis and management – IJOGR

  https://www.ijogr.org/html-article/20328

  Women with POI tend to have weaker bones as evident by decrease bone mineral density (BMD) and are more likely to have a fracture as they age because of hypoestrogenism. […] To keep their bones healthy and avoid osteoporosis, it is suggested that women take oestrogen replacement therapy in addition to consuming between 0.5 and 1.0 g of calcium and 400 to 800 IU of vitamin D daily, or a combination of the two. […] Hormone replacement therapy with early initiation is highly recommended in women with POI as it has beneficial effects on plasma lipids, blood pressure, insulin resistance, and endothelial function and also may reduce metabolic syndrome. […] Primary ovarian insufficiency (POI) treatment has the potential to be dramatically improved by new and upcoming medicines.

• #49 Primary ovarian insufficiency – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/diagnosis-treatment/drc-20354688

  Most often, treatment for primary ovarian insufficiency focuses on the problems that arise from estrogen deficiency. Treatment might include: […] Estrogen therapy can help prevent osteoporosis. It also can relieve hot flashes and other symptoms of low estrogen. You’ll likely be prescribed estrogen with the hormone progesterone if you still have your uterus. Adding progesterone protects the lining of your uterus, called the endometrium, from changes that could lead to cancer. These changes may be caused by taking estrogen alone. […] In older women, long-term estrogen plus progesterone treatment has been linked to a higher risk of heart and blood vessel disease and breast cancer. In young people with primary ovarian insufficiency, the benefits of hormone therapy outweigh the risks. […] Calcium and vitamin D supplements. Both nutrients are key for preventing osteoporosis. And you might not get enough of either in your diet or from sunlight.

• #50

  https://www.miracare.com/blog/primary-ovarian-insufficiency/

  HRT provides minimal side effects and is recommended for women with POI to help address symptoms that are associated with it. HRT of patients with POI is different from hormone therapies given to patients with menopause or other disease entities, which is why it is important to visit your health care provider first before taking these medications. […] Patients with POI are also given calcium and vitamin D supplements. They should have at least 1,200 mg to 1,500 mg of elemental calcium and 1,000 IU of vitamin D, this is to help avoid osteoporosis. Your doctor may suggest a bone mineral density check to see if you are at risk for osteoporosis and how aggressive your treatment may be for it. […] A healthy body weight and regular exercise are also recommended for patients with POI. A normal body weight will decrease the risk for cardiovascular risk and regular exercise helps decrease both weight and prevents osteoporosis.

• #51 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Hormone therapy gives your body the hormones that your ovaries aren’t making. Hormone therapy may involve taking just estrogen or taking estrogen and progesterone. Hormone therapy can help reduce symptoms of POI like night sweats and vaginal dryness. It will also lower your risk for osteoporosis and other conditions that POI can cause. Your provider may prescribe hormone therapy in different ways, such as a pill, cream, gel, patch or vaginal ring. […] If you begin HRT, you’ll continue treatment up until the age when natural menopause typically begins (age 51 to 52). Discuss the benefits and risks of HRT with your provider to make sure it’s right for you. […] In addition to HRT, other treatments could include: taking calcium and vitamin D to help lower your risk of osteoporosis; getting regular physical exercise, lifting weights (for your bone health) and maintaining a healthy weight; exploring options for fertility treatment if you wish to expand your family.

• #52 Primary ovarian insufficiency- An overview: Part 2 diagnosis and management – IJOGR

  https://www.ijogr.org/html-article/20328

  Women with POI tend to have weaker bones as evident by decrease bone mineral density (BMD) and are more likely to have a fracture as they age because of hypoestrogenism. […] To keep their bones healthy and avoid osteoporosis, it is suggested that women take oestrogen replacement therapy in addition to consuming between 0.5 and 1.0 g of calcium and 400 to 800 IU of vitamin D daily, or a combination of the two. […] Hormone replacement therapy with early initiation is highly recommended in women with POI as it has beneficial effects on plasma lipids, blood pressure, insulin resistance, and endothelial function and also may reduce metabolic syndrome. […] Primary ovarian insufficiency (POI) treatment has the potential to be dramatically improved by new and upcoming medicines.

• #53 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs consider screening for sarcopenia at POI diagnosis. […] The guideline group recommends that HCPs should offer vaginal estrogen therapy to improve genitourinary and sexual symptoms. […] The guideline group recommends that HCPs should be aware that estrogen therapy has beneficial cardiometabolic effects which can influence cardiovascular disease risk. […] The guideline group recommends that women with POI should have a regular clinical review, addressing individualised risk factors and adherence to therapy. […] The guideline group recommends that HCPs could consider non-hormonal pharmacologic and non-pharmacologic therapies for women with POI that are effective in peri-/postmenopausal women, although evidence specific to POI is lacking. […] The guideline group recommends that HCPs should enquire about use of complementary therapies and incorporate individual patient values and preferences into shared decision making about their use.

• #54

  https://www.miracare.com/blog/primary-ovarian-insufficiency/

  HRT provides minimal side effects and is recommended for women with POI to help address symptoms that are associated with it. HRT of patients with POI is different from hormone therapies given to patients with menopause or other disease entities, which is why it is important to visit your health care provider first before taking these medications. […] Patients with POI are also given calcium and vitamin D supplements. They should have at least 1,200 mg to 1,500 mg of elemental calcium and 1,000 IU of vitamin D, this is to help avoid osteoporosis. Your doctor may suggest a bone mineral density check to see if you are at risk for osteoporosis and how aggressive your treatment may be for it. […] A healthy body weight and regular exercise are also recommended for patients with POI. A normal body weight will decrease the risk for cardiovascular risk and regular exercise helps decrease both weight and prevents osteoporosis.

• #55 Primary Ovarian Insufficiency in Adolescents and Young Women | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/07/primary-ovarian-insufficiency-in-adolescents-and-young-women

  The addition of cyclic progesterone for 10-12 days each month is protective against endometrial hyperplasia and endometrial cancer, risks of unopposed estrogen. […] Patients and their families should be counseled on the effect of the patients condition on future fertility. Referrals to a reproductive endocrinology and infertility specialist should be made when desired by the patient and family to further discuss available reproductive treatments. […] In vitro fertilization with donor oocytes is often the most appropriate treatment; there are otherwise limited therapeutic options. […] Psychologic counseling also should be offered because impaired self-esteem and emotional distress have been reported after diagnosis of primary ovarian insufficiency.

• #56 Premature Ovarian Insufficiency: Causes, Symptoms, and Treatment

  https://patient.info/womens-health/menopause/premature-ovarian-insufficiency

  There are many different types of hormone treatments. If one type does not suit you then it is important to talk with your doctor in order to be given an alternative treatment. […] It is really important that you have a healthy lifestyle. This means that you should stop smoking if you smoke and you should eat a healthy, balanced diet. […] Many experts also recommend that you have adequate calcium in your diet or take calcium supplements and also take vitamin D supplements. […] If you are experiencing any mood changes (for example, feelings of anxiety, low mood or anger), it is very important that you seek help from your doctor. Some women find joining a support group and talking to other women with POI really helpful. […] With hormone treatment, the risk of both 'thinning’ of the bones (osteoporosis) reduces. Taking the correct dose and type of hormone treatment will also improve any symptoms you may be experiencing.

• #57 Premature Ovarian Insufficiency: A Review – European Medical Journal

  https://www.emjreviews.com/reproductive-health/article/premature-ovarian-insufficiency-a-review/

  There are various treatment options to improve fertility in these women. […] Pre-treatment with oestrogen suppresses FSH levels and allows restoration of FSH receptors in remaining follicles. […] Other new options are ovarian cortex transplantation and transplantation of an entire ovary. […] Because 5-10% of women with POI can have spontaneous resumption of ovulation, contraception should be provided to women not desirous of future fertility. […] Psychological support should be given in the form of counselling to the patients and appropriate treatment to those suffering from anxiety or depression.

• #58 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs consider screening for sarcopenia at POI diagnosis. […] The guideline group recommends that HCPs should offer vaginal estrogen therapy to improve genitourinary and sexual symptoms. […] The guideline group recommends that HCPs should be aware that estrogen therapy has beneficial cardiometabolic effects which can influence cardiovascular disease risk. […] The guideline group recommends that women with POI should have a regular clinical review, addressing individualised risk factors and adherence to therapy. […] The guideline group recommends that HCPs could consider non-hormonal pharmacologic and non-pharmacologic therapies for women with POI that are effective in peri-/postmenopausal women, although evidence specific to POI is lacking. […] The guideline group recommends that HCPs should enquire about use of complementary therapies and incorporate individual patient values and preferences into shared decision making about their use.

• #59

  https://bpac.org.nz/2019/ovarian.aspx

  Higher doses of MHT are recommended for women with primary ovarian insufficiency than women of menopausal age as the treatment goal is to achieve hormone levels in the pre-menopausal range. […] Various treatment options are available to manage primary ovarian insufficiency: High dose menopausal hormone therapy (MHT) […] A COC; for further information see: www.bpac.org.nz/2019/contraception/oral-contraceptives.aspx […] Currently, there is no conclusive evidence regarding the optimal hormone treatment regimen. Treatment selection should be individualised to improve adherence, taking into account any relevant history, contraindications to MHT or COC use, co-morbidities, need for contraception and patient preference. […] Women with primary ovarian insufficiency should be reviewed at least annually, including an assessment of symptom control, adherence to treatment and cardiovascular risk.

• #60 Premature ovarian insufficiency in general practice: Meeting the needs of women

  https://www.racgp.org.au/afp/2017/june/premature-ovarian-insufficiency-in-general-practic

  The IMS and ESHRE guidelines recommend that HRT be initiated early in all women diagnosed with POI (unless contraindicated) and continued until the natural age of menopause (approximately 51 years of age). […] Currently, there is no conclusive evidence regarding the optimal HRT regimen. Various factors require consideration in the selection of HRT preparations, and HRT should be individualised to improve adherence, taking into account women’s wishes. […] Women should be reviewed frequently while the dose of HRT is titrated. Once a maintenance dose is established, consultations should occur at least annually to monitor for symptom control and to complete an annual complication screen.

• #61 Primary Ovarian Insufficiency: A new paradigm for care and research

  https://researchfeatures.com/primary-ovarian-insufficiency-new-paradigm-care-research/

  Primary ovarian insufficiency (POI) is linked with lower levels of 17-Beta-Estradiol and is associated with poorer health outcomes. […] 17-Beta-Estradiol deficiency is also seen in POI. […] An integrated, long-term team approach to care is needed. […] Nelson suggests that removing the FDA box warnings from 17-Beta-Estradiol replacement therapies would allow clinicians to provide women with accurate information about available treatment options. […] One example of how this could be achieved is through a combination of physiological hormone replacement therapy to lower elevated serum luteinising hormone levels and avoid follicle luteinisation. […] A central, digital hub can support patients, their families, and healthcare providers by providing a convenient, up-to-date, cost-effective and integrated solution for rare health conditions in women, such as POI.

• #62 Committee Opinion No. 698: Hormone Therapy in Primary Ovarian Insufficiency – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28426619/

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 50-51 years). […] Finally, considering the challenges that adolescents and young women may face in coping with the physical, reproductive, and social effects of primary ovarian insufficiency, comprehensive longitudinal management of this condition is essential.

• #63 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #64 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  In contrast to the treatment of postmenopausal osteopenia or osteoporosis, which focuses on bisphosphonates as first-line therapy, low bone mass in women with primary ovarian insufficiency is managed most appropriately with HT. […] Women with primary ovarian insufficiency may experience hot flushes, night sweats, vaginal dryness, dyspareunia, and disordered sleep; some symptoms may develop before cycle irregularity. These symptoms routinely respond well to HT as indicated. […] Combined hormonal contraceptives prevent ovulation and pregnancy more reliably than HT; despite only modest odds of spontaneous pregnancy in women with primary ovarian insufficiency, this is a critical consideration for those who deem pregnancy prevention a priority. […] The approach to HT for primary ovarian insufficiency is full replacement doses of hormone for long-term treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency.

• #65 Primary Ovarian Insufficiency in Adolescents and Young Women | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/07/primary-ovarian-insufficiency-in-adolescents-and-young-women

  Optimal treatment of an adolescent in whom primary ovarian insufficiency is diagnosed requires special sensitivity to both the physical and emotional needs of young women receiving this diagnosis during a time of significant developmental changes. […] For adolescents with primary ovarian insufficiency, the objective of treatment is to replace the hormones that the ovary would be producing before the age of menopause, making the treatment distinctly different from hormonal therapy for menopause that focuses on the treatment of menopausal symptoms. The goals of hormonal therapy extend beyond simply symptom relief to levels that support bone, cardiovascular (CV), and sexual health. […] Once pubertal development is complete, ongoing hormonal therapy will be necessary for long-term health. Hormonal support involves daily therapy with the goal of maintenance of normal ovarian functioning levels of estradiol.

• #66 Primary Ovarian Insufficiency: Teenagers in Menopause

  https://www.nationwidechildrens.org/family-resources-education/700childrens/2022/11/primary-ovarian-insufficiency

  The main treatment for POI is hormone replacement therapy (HRT), with estrogen and progesterone. HRT is needed during the time your body would typically have it around, or the average age of menopause (early 50s). Taking hormones is important for heart and bone health and helps decrease symptoms like mood changes, vaginal dryness and hot flashes. It also helps girls who haven’t gone through puberty develop secondary sex characteristics (breast tissue, pubic hair). […] Estrogen helps build stronger bones and prevents heart disease. Estrogen patches (bandage-like stickers with medication that absorbs through the skin) are recommended because they are the best for bone health. Estrogen also comes in a pill form that some people prefer. Depending on if you’ve gone through puberty, you may start on a very low dose of estrogen and increase over time or you may start right away on a higher dose.

• #67 Primary Ovarian Insufficiency | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/p/primary-ovarian-insufficiency

  The treatment of POI is a team approach. Primary care doctors, gynecologists, endocrinologists and social workers help to care for these patients. […] Estrogen replacement therapy is recommended. In patients with POI, the ovaries do not make enough estrogen. Estrogen replacement helps patients to go through puberty, start having periods, grow taller, and build stronger bones. Estrogen is also important for keeping the heart and brain healthy. Patients usually get estrogen replacement through a skin patch that they change one to two times each week. […] Family planning is important. Patients with POI are less likely to get pregnant on their own, but there is still a small chance of pregnancy. Good birth control is important for patients who are in intimate relationships. We recommend talking with a doctor about this.

• #68 Primary Ovarian Insufficiency: Teenagers in Menopause

  https://www.nationwidechildrens.org/family-resources-education/700childrens/2022/11/primary-ovarian-insufficiency

  Progesterone helps to regulate periods and to prevent cancer of the uterus. It comes in many forms including pills, injection, arm implant or progesterone containing intra-uterine device. You may start it at the same time as estrogen or up to 2 years later depending on if you’ve gone through puberty yet.

• #69 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years).

• #70 Ovarian Insufficiency Treatment & Management: Medical Care, Further Outpatient Care, Consultations

  https://emedicine.medscape.com/article/271046-treatment

  Medical treatment of patients with POI/POF should address the following aspects: ovarian hormone replacement, restoration of fertility, and psychological well-being of the patient. […] The ovary is not only a reproductive organ but is also a source of important hormones that help maintain strong bones. Adequate replacement of these missing hormones, a healthy lifestyle, and a diet rich in calcium are essential. […] All women with POI/POF should receive cyclical HT with estrogens and progestins to relieve the symptoms of estrogen deficiency and to maintain bone density. […] Estrogens can be administered orally or transdermally. […] Progestins should be administered cyclically, 10-14 days each month, to prevent endometrial hyperplasia that unopposed estrogen may cause. […] Androgen replacement could be carefully considered for women who have persistent fatigue, low libido, and poor well being despite adequate estrogen replacement and when depression has been ruled out or adequately treated. […] No intervention has been proven to increase the ovulation rate or restore fertility in patients with POI/POF. […] Patients with POI/POF can have successful pregnancy with a donor egg. A decision to proceed with such a procedure should be made after a fair discussion of different options.

• #71 Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/03-2021/different-approaches-to-hormone-replacement-therapy-in-women-with-premature-ovarian-insufficiency/

  Premature ovarian insufficiency (POI) is a major burden in the lives of affected women, many of whom are still very young. […] This article summarizes the current recommendations on hormonal treatment of POI, discusses pros and cons of the various hormone preparations, sets out the beneficial effects of the different estrogen and progesterone preparations, and draws attention to possible disadvantages of certain preparations. […] Systemic hormone replacement is necessary to reduce these symptoms. Furthermore, if local symptoms such as vaginal atrophy and dyspareunia are present, additional topical estrogen administration may be indicated. […] HRT is recommended in POI to control symptoms and prevent subsequent consequences of ovarian hormone insufficiency. The term hormone replacement therapy is highly appropriate, as the hormones used replace what would be present physiologically.

• #72 Primary Ovarian Insufficiency: Teenagers in Menopause

  https://www.nationwidechildrens.org/family-resources-education/700childrens/2022/11/primary-ovarian-insufficiency

  The main treatment for POI is hormone replacement therapy (HRT), with estrogen and progesterone. HRT is needed during the time your body would typically have it around, or the average age of menopause (early 50s). Taking hormones is important for heart and bone health and helps decrease symptoms like mood changes, vaginal dryness and hot flashes. It also helps girls who haven’t gone through puberty develop secondary sex characteristics (breast tissue, pubic hair). […] Estrogen helps build stronger bones and prevents heart disease. Estrogen patches (bandage-like stickers with medication that absorbs through the skin) are recommended because they are the best for bone health. Estrogen also comes in a pill form that some people prefer. Depending on if you’ve gone through puberty, you may start on a very low dose of estrogen and increase over time or you may start right away on a higher dose.

• #73 What are the treatments for POI? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/poi/conditioninfo/treatments

  A healthcare provider may suggest that a woman with POI take HRT until she is about 50 years old, the age at which menopause usually begins. […] In general, HRT treatment for women with POI is safe and is associated with only minimal side effects. […] Women who have POI as well as one of these associated conditions will require additional treatment for the associated condition. In some cases, treatment involves medication or hormone therapy. Other types of treatments might also be needed.

• #74 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #75 Primary Ovarian Insufficiency | UMass Memorial Health

  https://www.ummhealth.org/health-library/primary-ovarian-insufficiency

  POI can be treated in different ways. Treatment may be done by a gynecologist who specializes in reproductive endocrinology. […] Most people with POI need hormone treatment with estrogen. This can help reduce bone loss and other symptoms of reduced estrogen, such as vaginal dryness. […] Progesterone is also given to people who have not had surgery to remove their uterus (hysterectomy) and are receiving estrogen. Your gynecologist will probably advise estrogen and progesterone until you reach the natural age for menopause (around age 50). […] Treatment of an underlying health problem may help treat POI. For example, treating thyroid disease or an eating disorder may reduce symptoms of POI. […] Pregnancy rates for people with POI are low. Many people with POI would like to have more children. If you have POI and still want to get pregnant, your gynecologist may recommend:

• #76 Treatment for Primary Ovarian Insufficiency (POI)

  https://myhealth.umassmemorial.org/Library/Healthsheets/3,S,90566

  Primary ovarian insufficiency (POI) is when the ovaries stop working before the age of 40. With POI, an ovary does not release an egg each month as it should. This can cause symptoms and make it hard to get pregnant. […] POI can be treated in different ways. Most people with POI need hormone treatment with estrogen. This can help reduce bone loss and other symptoms, such as vaginal dryness. You may also be given progesterone. This is for those who haven’t had surgery to remove their uterus (hysterectomy). […] In some people, treatment of another health condition may help treat POI. For example, treatment of thyroid disease or an eating disorder may reduce POI symptoms. […] Pregnancy rates for those with POI are low. If you have POI and still want to get pregnant, your healthcare provider may advise: Using a donor egg instead of your own egg […] Estrogen therapy as part of a combined hormonal treatment. […] A small number of people with POI can get pregnant naturally. Talk with your healthcare provider about birth control if you want to prevent pregnancy.

• #77 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #78 Premature Ovarian Failure POF – Primary Ovarian Insufficiency POI

  https://www.advancedfertility.com/patient-education/causes-of-infertility/premature-ovarian-failure

  Premature ovarian failure is a term used for the condition when women under age 40 have stopped having periods, and have high FSH levels and low estrogen hormone levels. […] Women with well documented premature ovarian failure should be considered for starting on estrogen/progestin replacement therapy if there are no contraindications. This will provide some protection against osteoporosis by eliminating the severely hypoestrogenic state associated with menopause. […] Regardless of the etiology, there currently is no effective treatment that will be likely to result in a pregnancy (with her own eggs) for premature ovarian failure. Egg donation is a highly successful treatment. […] Egg donation with in vitro fertilization (IVF) can be a very effective therapy for women with premature ovarian failure that desire pregnancy. In our donor egg program, we have approximately a 75% chance to have a baby with one attempt.

• #79 Primary ovarian insufficiency – Wikipedia

  https://en.wikipedia.org/wiki/Primary_ovarian_insufficiency

  Treatment will vary depending on the symptoms. It can include hormone replacement therapy, fertility management, and psychosocial support, as well as annual screenings of thyroid and adrenal function. […] Between 5 and 10% of women with POI may become pregnant with no treatment. […] As of 2016, no fertility treatment has been found to effectively increase fertility in women with POI, and the use of donor eggs with in-vitro fertilization (IVF) and adoption are a means of achieving parenthood for women with POI. […] Researchers have investigated the use of a hormone called dehydroepiandrosterone (DHEA) in women with POI to increase spontaneous pregnancy rates. […] In 2013, Kawamura in Japan and his collaborators at Stanford University published treatment of infertility of POI patients by fragmenting ovaries followed by in vitro treatment of ovarian fragments with phosphatidylinositol-3 kinase activators to enhance the AKT pathway followed by autografting.

• #80 Guide to primary ovarian insufficiency

  https://www.pollie.co/blog/guide-to-poi

  If POI is not identified until a person has already stopped ovulating, it is more likely that their body will be unresponsive to fertility treatment. However, most people with POI are still fully capable of carrying a pregnancy with a donor egg in conjunction with IVF. […] The treatment plan for POI may vary depending on the progression of the condition and the individual needs of the patient. It is important to consult with a healthcare provider to determine the appropriate treatment plan.

• #81 Primary Ovarian Insufficiency – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/primary-ovarian-insufficiency

  Other options for women who desire pregnancy include cryopreservation of ovarian tissue, oocytes, or embryos and embryo donation. […] Unless contraindicated, hormonal therapy or estrogen/progestin contraceptives are recommended rather than other bone-specific treatments (eg, bisphosphonates) to prevent bone loss in women with premature ovarian insufficiency; these treatments are given until women reach the average age for menopause (about age 51), when treatment may be reassessed. […] To help prevent osteoporosis, women with primary ovarian insufficiency should consume an adequate amount of calcium and vitamin D (in the diet and/or as supplements).

• #82 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs should be aware that a healthy lifestyle, including physical activity, has metabolic and heart benefits in the general population including postmenopausal women, although specific evidence on lifestyle interventions in POI is limited. […] The guideline group recommends that women with POI should be informed that there are no interventions that have been reliably shown to increase ovarian activity and natural conception rates. […] The guideline group recommends that women with POI should be informed that oocyte donation is an established option to achieve pregnancy after a diagnosis of POI.

• #83 Primary ovarian insufficiency – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/diagnosis-treatment/drc-20354688

  Most often, treatment for primary ovarian insufficiency focuses on the problems that arise from estrogen deficiency. Treatment might include: […] Estrogen therapy can help prevent osteoporosis. It also can relieve hot flashes and other symptoms of low estrogen. You’ll likely be prescribed estrogen with the hormone progesterone if you still have your uterus. Adding progesterone protects the lining of your uterus, called the endometrium, from changes that could lead to cancer. These changes may be caused by taking estrogen alone. […] In older women, long-term estrogen plus progesterone treatment has been linked to a higher risk of heart and blood vessel disease and breast cancer. In young people with primary ovarian insufficiency, the benefits of hormone therapy outweigh the risks. […] Calcium and vitamin D supplements. Both nutrients are key for preventing osteoporosis. And you might not get enough of either in your diet or from sunlight.

• #84 Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/03-2021/different-approaches-to-hormone-replacement-therapy-in-women-with-premature-ovarian-insufficiency/

  In addition to HRT, which is recommended for all women without contraindications to hormonal therapy, women with POI should substitute vitamin D3 and maintain a calcium- and vitamin D-rich diet. […] HRT has multifactorial significance for affected patients. In contrast to hormone administration after natural menopause, POI patients are treated for true hormone deficiency. In addition to treating estrogen deprivation symptoms, the therapy is also an effective primary preventive measure against long-term risks of POI, such as cardiovascular events and osteoporosis. […] For this purpose, HRT should be provided from the time of diagnosis until at least the age of natural menopause, and can be prescribed thereafter based on the individual wishes of the patient. […] There are few studies that address the optimal dosage of HRT for women with POI.

• #85

  https://www.miracare.com/blog/primary-ovarian-insufficiency/

  HRT provides minimal side effects and is recommended for women with POI to help address symptoms that are associated with it. HRT of patients with POI is different from hormone therapies given to patients with menopause or other disease entities, which is why it is important to visit your health care provider first before taking these medications. […] Patients with POI are also given calcium and vitamin D supplements. They should have at least 1,200 mg to 1,500 mg of elemental calcium and 1,000 IU of vitamin D, this is to help avoid osteoporosis. Your doctor may suggest a bone mineral density check to see if you are at risk for osteoporosis and how aggressive your treatment may be for it. […] A healthy body weight and regular exercise are also recommended for patients with POI. A normal body weight will decrease the risk for cardiovascular risk and regular exercise helps decrease both weight and prevents osteoporosis.

• #86 Primary ovarian insufficiency- An overview: Part 2 diagnosis and management – IJOGR

  https://www.ijogr.org/html-article/20328

  Women with POI tend to have weaker bones as evident by decrease bone mineral density (BMD) and are more likely to have a fracture as they age because of hypoestrogenism. […] To keep their bones healthy and avoid osteoporosis, it is suggested that women take oestrogen replacement therapy in addition to consuming between 0.5 and 1.0 g of calcium and 400 to 800 IU of vitamin D daily, or a combination of the two. […] Hormone replacement therapy with early initiation is highly recommended in women with POI as it has beneficial effects on plasma lipids, blood pressure, insulin resistance, and endothelial function and also may reduce metabolic syndrome. […] Primary ovarian insufficiency (POI) treatment has the potential to be dramatically improved by new and upcoming medicines.

• #87 Primary Ovarian Insufficiency – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/primary-ovarian-insufficiency

  Other options for women who desire pregnancy include cryopreservation of ovarian tissue, oocytes, or embryos and embryo donation. […] Unless contraindicated, hormonal therapy or estrogen/progestin contraceptives are recommended rather than other bone-specific treatments (eg, bisphosphonates) to prevent bone loss in women with premature ovarian insufficiency; these treatments are given until women reach the average age for menopause (about age 51), when treatment may be reassessed. […] To help prevent osteoporosis, women with primary ovarian insufficiency should consume an adequate amount of calcium and vitamin D (in the diet and/or as supplements).

• #88 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Hormone therapy gives your body the hormones that your ovaries aren’t making. Hormone therapy may involve taking just estrogen or taking estrogen and progesterone. Hormone therapy can help reduce symptoms of POI like night sweats and vaginal dryness. It will also lower your risk for osteoporosis and other conditions that POI can cause. Your provider may prescribe hormone therapy in different ways, such as a pill, cream, gel, patch or vaginal ring. […] If you begin HRT, you’ll continue treatment up until the age when natural menopause typically begins (age 51 to 52). Discuss the benefits and risks of HRT with your provider to make sure it’s right for you. […] In addition to HRT, other treatments could include: taking calcium and vitamin D to help lower your risk of osteoporosis; getting regular physical exercise, lifting weights (for your bone health) and maintaining a healthy weight; exploring options for fertility treatment if you wish to expand your family.

• #89 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs should be aware that a healthy lifestyle, including physical activity, has metabolic and heart benefits in the general population including postmenopausal women, although specific evidence on lifestyle interventions in POI is limited. […] The guideline group recommends that women with POI should be informed that there are no interventions that have been reliably shown to increase ovarian activity and natural conception rates. […] The guideline group recommends that women with POI should be informed that oocyte donation is an established option to achieve pregnancy after a diagnosis of POI.

• #90 Premature Ovarian Insufficiency: Causes, Symptoms, and Treatment

  https://patient.info/womens-health/menopause/premature-ovarian-insufficiency

  There are many different types of hormone treatments. If one type does not suit you then it is important to talk with your doctor in order to be given an alternative treatment. […] It is really important that you have a healthy lifestyle. This means that you should stop smoking if you smoke and you should eat a healthy, balanced diet. […] Many experts also recommend that you have adequate calcium in your diet or take calcium supplements and also take vitamin D supplements. […] If you are experiencing any mood changes (for example, feelings of anxiety, low mood or anger), it is very important that you seek help from your doctor. Some women find joining a support group and talking to other women with POI really helpful. […] With hormone treatment, the risk of both 'thinning’ of the bones (osteoporosis) reduces. Taking the correct dose and type of hormone treatment will also improve any symptoms you may be experiencing.

• #91 Premature ovarian insufficiency | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/premature-ovarian-insufficiency/

  In the longer term, the loss of ovarian hormones, particularly oestrogens, if not replaced, can result in osteoporosis and an increased risk of heart disease. Regular exercise is a good, general health measure that can help maintain bone health, as well as helping to protect against heart disease and stroke. Women with POI are also encouraged to stop smoking, reduce stress, and try to maintain a healthy weight to reduce the risk of heart disease.

• #92

  https://www.miracare.com/blog/primary-ovarian-insufficiency/

  HRT provides minimal side effects and is recommended for women with POI to help address symptoms that are associated with it. HRT of patients with POI is different from hormone therapies given to patients with menopause or other disease entities, which is why it is important to visit your health care provider first before taking these medications. […] Patients with POI are also given calcium and vitamin D supplements. They should have at least 1,200 mg to 1,500 mg of elemental calcium and 1,000 IU of vitamin D, this is to help avoid osteoporosis. Your doctor may suggest a bone mineral density check to see if you are at risk for osteoporosis and how aggressive your treatment may be for it. […] A healthy body weight and regular exercise are also recommended for patients with POI. A normal body weight will decrease the risk for cardiovascular risk and regular exercise helps decrease both weight and prevents osteoporosis.

• #93 Ovarian Insufficiency Treatment & Management: Medical Care, Further Outpatient Care, Consultations

  https://emedicine.medscape.com/article/271046-treatment

  Medical treatment of patients with POI/POF should address the following aspects: ovarian hormone replacement, restoration of fertility, and psychological well-being of the patient. […] The ovary is not only a reproductive organ but is also a source of important hormones that help maintain strong bones. Adequate replacement of these missing hormones, a healthy lifestyle, and a diet rich in calcium are essential. […] All women with POI/POF should receive cyclical HT with estrogens and progestins to relieve the symptoms of estrogen deficiency and to maintain bone density. […] Estrogens can be administered orally or transdermally. […] Progestins should be administered cyclically, 10-14 days each month, to prevent endometrial hyperplasia that unopposed estrogen may cause. […] Androgen replacement could be carefully considered for women who have persistent fatigue, low libido, and poor well being despite adequate estrogen replacement and when depression has been ruled out or adequately treated. […] No intervention has been proven to increase the ovulation rate or restore fertility in patients with POI/POF. […] Patients with POI/POF can have successful pregnancy with a donor egg. A decision to proceed with such a procedure should be made after a fair discussion of different options.

• #94 Reddit – The heart of the internet

  https://www.reddit.com/r/POFlife/comments/dy9ovc/pof_treatment_a_basic_primer/

  Continuous recommendation: 1-2mg oral estradiol (estrogen) daily with 2.5-5mg medroxyprogesterone (progesterone) pill daily or 100 mcg per day estradiol patch with 100mg micronized progesterone pill daily. […] In addition vaginal estrogen cream is recommended on top of the above for persisting symptoms of vaginal dryness, irritation, or urine leakage. […] Testosterone therapy or DHEA (which is related) is controversially recommended in women with low testosterone levels who have symptoms such as low libido. […] Treatment of POF is under researched, so a lot of these treatment guidelines are a combination of medical research and clinical experience from trial and error.

• #95 Primary ovarian insufficiency – Wikipedia

  https://en.wikipedia.org/wiki/Primary_ovarian_insufficiency

  Treatment will vary depending on the symptoms. It can include hormone replacement therapy, fertility management, and psychosocial support, as well as annual screenings of thyroid and adrenal function. […] Between 5 and 10% of women with POI may become pregnant with no treatment. […] As of 2016, no fertility treatment has been found to effectively increase fertility in women with POI, and the use of donor eggs with in-vitro fertilization (IVF) and adoption are a means of achieving parenthood for women with POI. […] Researchers have investigated the use of a hormone called dehydroepiandrosterone (DHEA) in women with POI to increase spontaneous pregnancy rates. […] In 2013, Kawamura in Japan and his collaborators at Stanford University published treatment of infertility of POI patients by fragmenting ovaries followed by in vitro treatment of ovarian fragments with phosphatidylinositol-3 kinase activators to enhance the AKT pathway followed by autografting.

• #96 Ovarian Insufficiency Treatment & Management: Medical Care, Further Outpatient Care, Consultations

  https://emedicine.medscape.com/article/271046-treatment

  Medical treatment of patients with POI/POF should address the following aspects: ovarian hormone replacement, restoration of fertility, and psychological well-being of the patient. […] The ovary is not only a reproductive organ but is also a source of important hormones that help maintain strong bones. Adequate replacement of these missing hormones, a healthy lifestyle, and a diet rich in calcium are essential. […] All women with POI/POF should receive cyclical HT with estrogens and progestins to relieve the symptoms of estrogen deficiency and to maintain bone density. […] Estrogens can be administered orally or transdermally. […] Progestins should be administered cyclically, 10-14 days each month, to prevent endometrial hyperplasia that unopposed estrogen may cause. […] Androgen replacement could be carefully considered for women who have persistent fatigue, low libido, and poor well being despite adequate estrogen replacement and when depression has been ruled out or adequately treated. […] No intervention has been proven to increase the ovulation rate or restore fertility in patients with POI/POF. […] Patients with POI/POF can have successful pregnancy with a donor egg. A decision to proceed with such a procedure should be made after a fair discussion of different options.

• #97 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs consider screening for sarcopenia at POI diagnosis. […] The guideline group recommends that HCPs should offer vaginal estrogen therapy to improve genitourinary and sexual symptoms. […] The guideline group recommends that HCPs should be aware that estrogen therapy has beneficial cardiometabolic effects which can influence cardiovascular disease risk. […] The guideline group recommends that women with POI should have a regular clinical review, addressing individualised risk factors and adherence to therapy. […] The guideline group recommends that HCPs could consider non-hormonal pharmacologic and non-pharmacologic therapies for women with POI that are effective in peri-/postmenopausal women, although evidence specific to POI is lacking. […] The guideline group recommends that HCPs should enquire about use of complementary therapies and incorporate individual patient values and preferences into shared decision making about their use.

• #98 Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/03-2021/different-approaches-to-hormone-replacement-therapy-in-women-with-premature-ovarian-insufficiency/

  Premature ovarian insufficiency (POI) is a major burden in the lives of affected women, many of whom are still very young. […] This article summarizes the current recommendations on hormonal treatment of POI, discusses pros and cons of the various hormone preparations, sets out the beneficial effects of the different estrogen and progesterone preparations, and draws attention to possible disadvantages of certain preparations. […] Systemic hormone replacement is necessary to reduce these symptoms. Furthermore, if local symptoms such as vaginal atrophy and dyspareunia are present, additional topical estrogen administration may be indicated. […] HRT is recommended in POI to control symptoms and prevent subsequent consequences of ovarian hormone insufficiency. The term hormone replacement therapy is highly appropriate, as the hormones used replace what would be present physiologically.

• #99 Reddit – The heart of the internet

  https://www.reddit.com/r/POFlife/comments/dy9ovc/pof_treatment_a_basic_primer/

  Continuous recommendation: 1-2mg oral estradiol (estrogen) daily with 2.5-5mg medroxyprogesterone (progesterone) pill daily or 100 mcg per day estradiol patch with 100mg micronized progesterone pill daily. […] In addition vaginal estrogen cream is recommended on top of the above for persisting symptoms of vaginal dryness, irritation, or urine leakage. […] Testosterone therapy or DHEA (which is related) is controversially recommended in women with low testosterone levels who have symptoms such as low libido. […] Treatment of POF is under researched, so a lot of these treatment guidelines are a combination of medical research and clinical experience from trial and error.

• #100 Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/03-2021/different-approaches-to-hormone-replacement-therapy-in-women-with-premature-ovarian-insufficiency/

  Premature ovarian insufficiency (POI) is a major burden in the lives of affected women, many of whom are still very young. […] This article summarizes the current recommendations on hormonal treatment of POI, discusses pros and cons of the various hormone preparations, sets out the beneficial effects of the different estrogen and progesterone preparations, and draws attention to possible disadvantages of certain preparations. […] Systemic hormone replacement is necessary to reduce these symptoms. Furthermore, if local symptoms such as vaginal atrophy and dyspareunia are present, additional topical estrogen administration may be indicated. […] HRT is recommended in POI to control symptoms and prevent subsequent consequences of ovarian hormone insufficiency. The term hormone replacement therapy is highly appropriate, as the hormones used replace what would be present physiologically.

• #101 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs consider screening for sarcopenia at POI diagnosis. […] The guideline group recommends that HCPs should offer vaginal estrogen therapy to improve genitourinary and sexual symptoms. […] The guideline group recommends that HCPs should be aware that estrogen therapy has beneficial cardiometabolic effects which can influence cardiovascular disease risk. […] The guideline group recommends that women with POI should have a regular clinical review, addressing individualised risk factors and adherence to therapy. […] The guideline group recommends that HCPs could consider non-hormonal pharmacologic and non-pharmacologic therapies for women with POI that are effective in peri-/postmenopausal women, although evidence specific to POI is lacking. […] The guideline group recommends that HCPs should enquire about use of complementary therapies and incorporate individual patient values and preferences into shared decision making about their use.

• #102 Best Homeopathy Treatment of Primary Ovarian Insufficiency

  https://wellinghomeopathy.com/fertility-treatment/primary-ovarian-insufficiency/

  Managing stress is an important part of living with POI. Techniques such as mindfulness meditation, yoga, counseling, and other stress-reduction strategies can help mitigate the impact of stress on the body. Integrating these practices into daily life can improve overall well-being and potentially reduce the severity of POI symptoms.

• #103 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs consider screening for sarcopenia at POI diagnosis. […] The guideline group recommends that HCPs should offer vaginal estrogen therapy to improve genitourinary and sexual symptoms. […] The guideline group recommends that HCPs should be aware that estrogen therapy has beneficial cardiometabolic effects which can influence cardiovascular disease risk. […] The guideline group recommends that women with POI should have a regular clinical review, addressing individualised risk factors and adherence to therapy. […] The guideline group recommends that HCPs could consider non-hormonal pharmacologic and non-pharmacologic therapies for women with POI that are effective in peri-/postmenopausal women, although evidence specific to POI is lacking. […] The guideline group recommends that HCPs should enquire about use of complementary therapies and incorporate individual patient values and preferences into shared decision making about their use.

• #104 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years).

• #105 Committee Opinion No. 698: Hormone Therapy in Primary Ovarian Insufficiency – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28426619/

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 50-51 years). […] Finally, considering the challenges that adolescents and young women may face in coping with the physical, reproductive, and social effects of primary ovarian insufficiency, comprehensive longitudinal management of this condition is essential.

• #106 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #107 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Hormone therapy gives your body the hormones that your ovaries aren’t making. Hormone therapy may involve taking just estrogen or taking estrogen and progesterone. Hormone therapy can help reduce symptoms of POI like night sweats and vaginal dryness. It will also lower your risk for osteoporosis and other conditions that POI can cause. Your provider may prescribe hormone therapy in different ways, such as a pill, cream, gel, patch or vaginal ring. […] If you begin HRT, you’ll continue treatment up until the age when natural menopause typically begins (age 51 to 52). Discuss the benefits and risks of HRT with your provider to make sure it’s right for you. […] In addition to HRT, other treatments could include: taking calcium and vitamin D to help lower your risk of osteoporosis; getting regular physical exercise, lifting weights (for your bone health) and maintaining a healthy weight; exploring options for fertility treatment if you wish to expand your family.

• #108 Reddit – The heart of the internet

  https://www.reddit.com/r/POFlife/comments/dy9ovc/pof_treatment_a_basic_primer/

  This is meant to be a basic introduction to treatment recommendations. […] POF should absolutely be treated with very rare exception. Treatment should not be delayed unless there is a clear medical reason not to treat. […] Hormone therapy is an effective treatment for all of these complications of low estrogen and decreases these long term health complications, and also improves mental health and quality of life. Because of this it is recommended that all women with POI receive hormone therapy until the average age of natural menopause, 51. […] First line (gold standard) treatment is estrogen supplementation via pills or patches. Progesterone therapy is also recommended if you have a uterus because estrogen alone can lead to overgrowth of the uterine lining, which is a risk for endometrial cancer.

• #109 Reddit – The heart of the internet

  https://www.reddit.com/r/POFlife/comments/dy9ovc/pof_treatment_a_basic_primer/

  Continuous recommendation: 1-2mg oral estradiol (estrogen) daily with 2.5-5mg medroxyprogesterone (progesterone) pill daily or 100 mcg per day estradiol patch with 100mg micronized progesterone pill daily. […] In addition vaginal estrogen cream is recommended on top of the above for persisting symptoms of vaginal dryness, irritation, or urine leakage. […] Testosterone therapy or DHEA (which is related) is controversially recommended in women with low testosterone levels who have symptoms such as low libido. […] Treatment of POF is under researched, so a lot of these treatment guidelines are a combination of medical research and clinical experience from trial and error.

• #110 Primary ovarian insufficiency – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/diagnosis-treatment/drc-20354688

  No treatment is proven to restore fertility. But some people with primary ovarian insufficiency and their partners try to become pregnant through a procedure called in vitro fertilization. The procedure involves removing eggs from a donor and fertilizing them with sperm. A fertilized egg, called an embryo, is then placed in the uterus.

• #111 Premature Ovarian Failure POF – Primary Ovarian Insufficiency POI

  https://www.advancedfertility.com/patient-education/causes-of-infertility/premature-ovarian-failure

  Premature ovarian failure is a term used for the condition when women under age 40 have stopped having periods, and have high FSH levels and low estrogen hormone levels. […] Women with well documented premature ovarian failure should be considered for starting on estrogen/progestin replacement therapy if there are no contraindications. This will provide some protection against osteoporosis by eliminating the severely hypoestrogenic state associated with menopause. […] Regardless of the etiology, there currently is no effective treatment that will be likely to result in a pregnancy (with her own eggs) for premature ovarian failure. Egg donation is a highly successful treatment. […] Egg donation with in vitro fertilization (IVF) can be a very effective therapy for women with premature ovarian failure that desire pregnancy. In our donor egg program, we have approximately a 75% chance to have a baby with one attempt.

• #112 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs consider screening for sarcopenia at POI diagnosis. […] The guideline group recommends that HCPs should offer vaginal estrogen therapy to improve genitourinary and sexual symptoms. […] The guideline group recommends that HCPs should be aware that estrogen therapy has beneficial cardiometabolic effects which can influence cardiovascular disease risk. […] The guideline group recommends that women with POI should have a regular clinical review, addressing individualised risk factors and adherence to therapy. […] The guideline group recommends that HCPs could consider non-hormonal pharmacologic and non-pharmacologic therapies for women with POI that are effective in peri-/postmenopausal women, although evidence specific to POI is lacking. […] The guideline group recommends that HCPs should enquire about use of complementary therapies and incorporate individual patient values and preferences into shared decision making about their use.

• #113 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The guideline group recommends that HCPs should be aware that a healthy lifestyle, including physical activity, has metabolic and heart benefits in the general population including postmenopausal women, although specific evidence on lifestyle interventions in POI is limited. […] The guideline group recommends that women with POI should be informed that there are no interventions that have been reliably shown to increase ovarian activity and natural conception rates. […] The guideline group recommends that women with POI should be informed that oocyte donation is an established option to achieve pregnancy after a diagnosis of POI.

• #114 Premature Ovarian Insufficiency: Causes, Symptoms, and Treatment

  https://patient.info/womens-health/menopause/premature-ovarian-insufficiency

  There are many different types of hormone treatments. If one type does not suit you then it is important to talk with your doctor in order to be given an alternative treatment. […] It is really important that you have a healthy lifestyle. This means that you should stop smoking if you smoke and you should eat a healthy, balanced diet. […] Many experts also recommend that you have adequate calcium in your diet or take calcium supplements and also take vitamin D supplements. […] If you are experiencing any mood changes (for example, feelings of anxiety, low mood or anger), it is very important that you seek help from your doctor. Some women find joining a support group and talking to other women with POI really helpful. […] With hormone treatment, the risk of both 'thinning’ of the bones (osteoporosis) reduces. Taking the correct dose and type of hormone treatment will also improve any symptoms you may be experiencing.

• #115 Premature ovarian insufficiency in general practice: Meeting the needs of women

  https://www.racgp.org.au/afp/2017/june/premature-ovarian-insufficiency-in-general-practic

  The IMS and ESHRE guidelines recommend that HRT be initiated early in all women diagnosed with POI (unless contraindicated) and continued until the natural age of menopause (approximately 51 years of age). […] Currently, there is no conclusive evidence regarding the optimal HRT regimen. Various factors require consideration in the selection of HRT preparations, and HRT should be individualised to improve adherence, taking into account women’s wishes. […] Women should be reviewed frequently while the dose of HRT is titrated. Once a maintenance dose is established, consultations should occur at least annually to monitor for symptom control and to complete an annual complication screen.

• #116 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  Primary ovarian insufficiency, also called primary ovarian failure, is a rare condition where your ovaries stop working before age 40. It causes irregular menstrual periods and often leads to infertility. Hormone therapy (HT) is the most common treatment. […] Many women with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications. […] Healthcare providers treat POI in different ways. It depends on your age, symptoms and if you wish to get pregnant. Primary ovarian insufficiency treatment involves: replacing hormones that your ovaries no longer produce; treating symptoms or side effects of POI (like night sweats, vaginal dryness, etc.); lowering your risk for conditions that POI causes; treating underlying conditions that worsen POI symptoms.

• #117 Premature ovarian insufficiency in general practice: Meeting the needs of women

  https://www.racgp.org.au/afp/2017/june/premature-ovarian-insufficiency-in-general-practic

  The diagnosis of POI can be extremely distressing for women. Several consultations may be required to provide emotional and psychological support regarding the diagnosis, and to address the multisystem approach needed for optimal care. […] After a long discussion with the patient about the diagnosis of POI, its clinical implications and her plans for pregnancy, the importance of oestrogen therapy until the average age of menopause (approximately 51 years of age) is explained. Our patient commences transdermal combined continuous HRT (containing 50 g oestradiol and 140 g norethisterone). […] Management of women with POI requires a multidisciplinary team approach to address the psychological impact of the diagnosis, initiate HRT (if not contraindicated) and/or contraceptive options, manage menopausal symptoms and long-term consequences, address the underlying cause of POI, and infertility treatment. Comprehensive guidelines on the management of women with POI were recently published, and key points from this review are highlighted below.

• #118 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

  No, primary ovarian insufficiency isn’t reversible. Healthcare providers can treat symptoms, side effects and associated conditions, but they can’t cure it. […] About 25% of women with POI may experience ovulation at least once even after diagnosis. However, there isn’t treatment that can make your ovaries start to work again. Treatment for primary ovarian insufficiency helps relieve symptoms of the condition and lowers your risk of health conditions that POI may cause.

• #119 Primary Ovarian Insufficiency Arlington, VA

  https://nvpwomen.com/womens-health/healthwise?DOCHWID=uf6200spec

  Treatment for primary ovarian insufficiency will help you manage your symptoms. But there is currently no treatment that will make the ovaries start to work properly again. Your doctor may prescribe hormone therapy or other medicines to help with hot flashes. Hormone therapy can also help prevent early bone loss. Talk to your doctor about which treatments may be right for you. […] Some people with primary ovarian insufficiency may choose to try to become pregnant using donor eggs and in vitro fertilization.

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