Materiały źródłowe

• #1

  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. […] The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. […] 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.

• #1 Primary Ovarian Insufficiency | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/primary-ovarian-insuffiency

  Primary ovarian insufficiency (POI), also called premature ovarian failure, occurs when the ovaries have a decrease in estrogen production and ovulation before a woman turns 40. The most common sign of POI is irregular or missed menstrual periods. Periods may occur off and on, or may start again many years after POI is diagnosed. Due to the drop in estrogen levels, women with POI may also have menopause-like symptoms, including: Night sweats, Hot flashes, Vaginal dryness, Irritability, depression, or anxiety, Trouble sleeping, Trouble with concentration or memory. Because women with POI have low levels of estrogen at a young age, several health problems are more common than in women without POI: Infertility: Most women with POI cannot get pregnant naturally. They often can carry a pregnancy but most need to use donor eggs. Osteoporosis: Low levels of estrogen increase the risk of bone loss and fractures. Heart Disease: Low estrogen early in life appears to increase the risk of heart attack as a woman age. Depression: Many women with POI feel sadness about their unexpected loss of ovarian function. Women with POI should talk about these feelings with their medical provider and may want to talk to a therapist. If you have POI, you may also be more likely to develop other hormone-related disorders. Women with POI should be checked periodically for deficiencies in thyroid and adrenal gland hormones.

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

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

  Primary ovarian insufficiency causes low estrogen levels. Losing estrogen can have side effects similar to those that occur with menopause, such as hot flashes, decreased sex drive and mood changes. It also increases your risk for osteoporosis, heart disease and other conditions. […] The most common sign of POI is irregular or missed periods. Some women with primary ovarian insufficiency dont have any noticeable symptoms. Other symptoms can include: Irregular or missed periods. Trouble getting pregnant. Decreased sex drive. Difficulty concentrating. Irritability. Dry eyes. Hot flashes and night sweats. Vaginal dryness. Painful sex due to vaginal dryness. […] Primary ovarian insufficiency is usually permanent. Most women with the condition take long-term hormone therapy to manage symptoms and reduce the risk of complications. […] Primary ovarian insufficiency often causes feelings of sadness and loss, especially if you still had hopes for getting pregnant. Support groups and counseling are available. These supports can help you manage emotions and find ways to cope.

• #1 Primary Ovarian Insufficiency Quiz: Check Possibility & Treatment with Ubie AI Symptom Checker

  https://ubiehealth.com/diseases/premature-ovarian-failure

  Typical Symptoms of Primary Ovarian Insufficiency: […] – Hot flashes […] – Sweating at night requiring change in clothing […] – No periods for one year […] – History of radiation therapy […] – Irregular periods […] – Decreased vaginal discharge […] – Difficulty getting pregnant […] – Unusual changes in period […] […] Symptoms Related to Primary Ovarian Insufficiency: […] – Lot of sweating at night […] – Irregular periods […] – Infertility […] – Abnormal period […] – Bleeding between periods

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

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

  Premature ovarian insufficiency is sometimes called premature ovarian failure. The condition occurs when your ovaries no longer work properly when you are under the age of 40 years. Your ovaries no longer produce normal amounts of oestrogen and therefore may not produce eggs. This means that your periods stop (or become irregular) and you may experience symptoms of the menopause. With premature ovarian insufficiency your ovaries are not working properly and have stopped producing eggs early. In some women, however, this loss of function is temporary and their ovaries work and function again in the future. This means that you may find that your periods return at some stage in the future. Therefore premature ovarian insufficiency is not necessarily the same as premature menopause, which means the irreversible loss of ovarian function before the age of 40 years. For most women, the most common symptom is that their periods stop. For around 1 in 10 women with premature ovarian insufficiency (POI), their periods do not start and they present with POI at a very early age, usually under 20 years. Other women may notice that their periods become irregular. Many women experience symptoms of the menopause. These include hot flushes, night sweats, reduced energy, mood disturbances, loss of energy and loss of sex drive. Some women notice that their hair becomes thinner and they have some joint pains. However, around 1 in 4 women do not have any of these symptoms. It can be very common to feel anxious, be worried or even have feelings of hopelessness after a diagnosis of POI has been made. Some women find they feel very sad and even guilty, as having POI affects fertility. The low level of oestrogen in your body can lead to 'thinning’ of the bones (osteoporosis) developing which can then lead to fractures developing in your bones. There is also an increased risk of heart attacks at a young age. However, these increased risks are all reversed by taking hormone treatment. 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.

• #1 Primary ovarian insufficiency – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683

  Symptoms of primary ovarian insufficiency are like those of menopause or low estrogen. They include: […] Irregular or missed periods. This symptom might be present for years. It also could develop after a pregnancy or after stopping birth control pills. […] Trouble getting pregnant. […] Hot flashes and night sweats. […] Vaginal dryness. […] Anger, depression or anxiety. […] Trouble with focus or memory. […] Less sexual desire. […] Primary ovarian insufficiency can lead to other health conditions, including the following: […] Infertility. Not being able to get pregnant can be a complication of primary ovarian insufficiency. Rarely, pregnancy is possible until the body’s supply of eggs runs out. […] Osteoporosis. This condition causes bones to become weak, brittle and more likely to break. Women with low levels of the hormone estrogen have a higher risk of getting osteoporosis. That’s because estrogen helps keep bones strong.

• #1 Premature & Early Menopause: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause

  Premature menopause and early menopause are conditions where a woman goes through menopause at an earlier age than is typically expected. […] POI is a condition where your periods stop suddenly and spontaneously, either early or prematurely. […] People with POI may still ovulate, menstruate or become pregnant. […] The other signs of premature and early menopause include many of the typical menopause symptoms. You may experience: Hot flashes (sudden warmth that spreads over your body). Night sweats. Vaginal dryness and discomfort during sex. Frequent urge to pee. More frequent urinary tract infections (UTIs). Difficulty sleeping (insomnia). Emotional changes (irritability, mood swings, depression or anxiety). Dry skin, dry eyes or dry mouth. Breast tenderness. Racing heart. Headaches. Joint and muscle aches and pains. Changes in your sex drive (libido). Difficulty concentrating or being more forgetful. Weight gain or weight loss. Hair loss or thinning.

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

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

  Other things that may be signs or symptoms of POI: Not having menstrual periods, or having menstrual periods less often instead of monthly, Hot flashes, Night sweats, Trouble sleeping, Mood changes, Vaginal dryness, Weaker bones, In adult patients: difficulty getting pregnant. Some patients will have only one of these symptoms, and other patients will have many.

• #1 Primary Ovarian Insufficiency (POI): Causes, Symptoms and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/primary-ovarian-insufficiency

  Women with POI may have the following symptoms: […] No menstrual period […] Irregular menstrual periods […] Menstrual periods that stop completely […] Hot flushes […] Vaginal dryness […] Painful intercourse

• #1 Primary Ovarian Insufficiency

  https://ketteringhealth.org/conditions/primary-ovarian-insufficiency/

  When the ovaries stop working normally in women younger than age 40, it’s called primary ovarian insufficiency (POI). […] Someone with POI may have fewer eggs. Or the ovaries might not mature or release eggs correctly. The ovaries then don’t make the normal amounts of hormones. This leads to the symptoms of POI. […] Most people with POI have a normal puberty and have normal menstrual periods before symptoms start. Symptoms may include: Decreased sex drive, Hot flashes and night sweats, Infertility, Irregular periods or periods that completely stop, Irritability, Painful sex because of thinning and drying of the vagina. […] Some people with POI have regular periods and don’t have any symptoms of POI. Others may have symptoms that come and go. […] Infertility, irregular menstrual cycles, vaginal dryness, and irritability are some possible symptoms of POI. Some women with POI don’t have any of these symptoms.

• #1 Primary Ovarian Insufficiency (Premature Ovarian Failure)

  https://www.webmd.com/menopause/premature-ovarian-failure

  Primary ovarian insufficiency used to be called premature ovarian failure. Its a condition that affects women well before they should reach menopause. […] If youre younger than 40 and your ovaries no longer make eggs and your periods have stopped, it may be primary ovarian insufficiency. […] The most common symptoms of premature ovarian failure are missed or infrequent periods. Periods may start and stop again for many years. Other symptoms can seem like those of menopause and may include: Hot flashes, Night sweats, Anxiety, depression, or mood swings, Concentration or memory problems, Your sex drive isnt what it used to be, Trouble sleeping, Vaginal dryness, which can make sex uncomfortable. […] Your doctor may diagnose you with primary ovarian insufficiency if youre under age 40 and have any of the following: High FSH levels (in the menopause range) on two different tests done at least 1 month apart, Low estradiol level, which means your ovaries arent making enough estrogen, No periods or irregular periods (less often than every 35 days) for 3 months in a row. […] Women with primary ovarian insufficiency usually have smaller ovaries with few follicles.

• #1 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  Primary ovarian insufficiency (POI) is a disease that affects women less than 40 years of age. Commonly, women present with amenorrhea for 4-6 months, low estradiol levels, and elevated follicle-stimulating hormone (FSH) level. POI affects mental health, fertility, cardiovascular health, and bone health. The typical onset of POI is in women less than 40 years of age and is diagnosed in the setting of amenorrhea lasting 4-6 months in combination with elevated follicle-stimulating hormone (FSH) and decreased estradiol levels obtained one month apart. POI differs from menopause due to the remaining variability of ovarian function and primordial follicles, whereas menopause occurs when primordial follicles are exhausted, resulting in the cessation of menstruation altogether. Normal menstruation and regular ovulation have significant impacts on female health overall. For example, in the absence of normal ovarian function in decreased estradiol, sex steroid production is reduced, leading to inadequate bone density and the development of osteoporosis or osteopenia. This greatly increases a woman’s risk of bone fracture. As a result, it is of great importance for POI to be recognized early within its disease process in order to prevent and reduce the morbidity and mortality associated with hypoestrogenemia and to increase the quality of life of the women affected. The course of POI is variable and unpredictable. As such, approximately 4-10% of women with POI may conceive naturally and approximately 20% will have successful ovulation induction. However, due to the variability of the disease, the overall success of pregnancy and live birth only reaches 25% after cryopreservation and implantation of embryos. A woman’s probability of pregnancy increases to approximately 40% in the setting of oocyte donation after one cycle of IVF and climbs to 70-80% with four cycles of IVF. The diagnosis of primary ovarian insufficiency should be based upon strong evidence after any confounding disease processes have been excluded. This diagnosis carries with it severe implications on a woman’s future health, fertility, and psychological well-being, as discussed above. Currently, there are no treatment modalities that can reverse the damage done to healthy oocytes, increase the functionality of existing oocytes, or even generate new oocytes. Spontaneous pregnancy may be achieved as the course of POI is unpredictable. However, this chance remains low. If a woman with POI desires fertility, the mainstay of successful treatment remains oocyte donation. Symptoms of POI such as hot flashes, mood irritability, night sweats, sleep disturbance, vaginal dryness/irritation, and dyspareunia can be a nuisance for women. However, they are not life-threatening and can be improved by hormone replacement. Overall, the greatest health impact of POI affects a woman’s cardiovascular health, leading to early mortality from ischemic heart disease.

• #1 Patient education: Primary ovarian insufficiency (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/primary-ovarian-insufficiency-beyond-the-basics

  Symptoms of primary ovarian insufficiency (POI) can include menstrual and hormonal changes, infertility, and emotional symptoms. […] Most people with POI go through normal puberty and have regular periods before their ovaries stop working normally. They most often seek medical attention when their period becomes irregular or infrequent. […] With POI, the ovaries eventually stop working, making it impossible to get pregnant naturally. […] Because the body eventually produces little or no estrogen, people with POI can also have symptoms of menopause, like hot flashes, night sweats, and sleep disturbances. […] It can be very upsetting to learn that you have POI, especially if you were planning to get pregnant in the future. It is normal to feel sad or stressed. Some people develop symptoms of depression or anxiety.

• #1 Primary Ovarian Insufficiency: What to Expect

  https://flo.health/menstrual-cycle/health/symptoms-and-diseases/primary-ovarian-insufficiency

  Other symptoms of POI can include: Your period suddenly stopping, Changes in skin pigmentation, Vitiligo, an autoimmune disorder that causes patches of skin discoloration, Hyperpigmentation, Adrenal insufficiency, Hair loss, Fatigue, Anxiety or depression without a prior history of clinical depression or generalized anxiety disorder, Goiter. […] If youre experiencing irregular or missed periods, menopausal symptoms, or are having trouble conceiving, its better to speak with your doctor. POI may be one of many medical conditions affecting your menstrual cycle. […] Primary ovarian insufficiency can be caused by several different factors. While treating an underlying medical condition can help reduce some of the hormone-based side effects of POI, it may restore your ability to ovulate regularly. Pregnancy may still be possible with POI, but it can be challenging. Finally, even if you arent trying to conceive with POI, you should still seek treatment to reduce the chances of developing heart disease or osteoporosis.

• #1 Primary Ovarian Insufficiency | POI | MedlinePlus

  https://medlineplus.gov/primaryovarianinsufficiency.html

  Primary ovarian insufficiency (POI), also known as premature ovarian failure, happens when a woman’s ovaries stop working normally before she is 40. […] The first sign of POI is usually irregular or missed periods. Later symptoms may be similar to those of natural menopause: Hot flashes, Night sweats, Irritability, Poor concentration, Decreased sex drive, Pain during sex, Vaginal dryness. […] For many women with POI, trouble getting pregnant or infertility is the reason they go to their health care provider.

• #1 Primary Ovarian Insufficiency | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/primary-ovarian-insufficiency.html

  When the ovaries stop working normally in women younger than age 40, it’s called primary ovarian insufficiency (POI). […] Someone with POI may have fewer eggs. Or the ovaries might not mature or release eggs correctly. The ovaries then don’t make the normal amounts of hormones. This leads to the symptoms of POI. […] Most people with POI have a normal puberty and have normal menstrual periods before symptoms start. Symptoms may include: […] Infertility, irregular menstrual cycles, vaginal dryness, and irritability are some possible symptoms of POI. Some women with POI don’t have any of these symptoms. […] Estrogen therapy is the main treatment for the symptoms of POI.

• #1 Ovarian Insufficiency: Practice Essentials, Background, Pathophysiology

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

  Primary ovarian insufficiency (POI) (premature ovarian failure, premature menopause, or early menopause) is a condition characterized by amenorrhea, hypoestrogenism, and elevated serum gonadotropin levels in women younger than 40 years. […] Most women with POI retain intermittent ovarian function for many years, and, unlike women who are menopausal, pregnancies may occur. […] Women with spontaneous POI/POF have a low but real chance of spontaneous pregnancy. Approximately 5-10% become pregnant subsequent to the diagnosis of POI/POF. […] The prognosis for women with secondary ovarian insufficiency depends on the etiology of the disorder. […] A long-lasting hypoestrogenic state at a young age may prevent women from achieving and maintaining adequate bone density. This may put them at increased risk for osteoporosis and fractures later in life. […] Women with POI/POF may be at higher risk for cardiovascular diseases, again due to low estrogen levels.

• #1 Signs and Symptoms of Primary Ovarian Insufficiency | Obgyn Key

  https://obgynkey.com/signs-and-symptoms-of-primary-ovarian-insufficiency/

  In our cohort, 46 % of women reported currently experiencing hot flushes, 40 % experience night sweats, and 34 % reported sweating. […] Women who experienced more severe symptoms demonstrated lower levels of mindfulness as measured by the CAMS-R in each domain and overall. Additionally, women reporting mental fog in the past 30 days reported lower levels of mindfulness than women not reporting mental fog. […] A history of depression is highly prevalent among women with POF/POI, as demonstrated by our cohort where 43 % of women reported a history including a diagnosis of depression. The association between POF/POI and depression has been suggested to be overlapping pathophysiology or bidirectional in our cohort, as opposed to causal.

• #1 Signs and Symptoms of Premature Ovarian Insufficiency

  https://www.daisynetwork.org/about-poi/signs-and-symptoms/

  The following symptoms can all be indicators that you may be entering or experiencing POI: Irregular periods or periods stopping this is the most common reason for recognising that something is not right […] Infertility […] Hot flushes and night sweats […] Insomnia/disrupted sleep […] Palpitations […] Weight gain (especially around waist and abdomen) […] Skin and hair changes (dryness, thinning) […] Headaches […] Breast tenderness […] Mood swings and irritability […] Anxiety/panic attacks […] Loss of self-esteem […] Lowered libido […] Difficulty concentrating and memory lapses […] Fatigue/low energy levels […] Joint/muscle pain […] Vaginal dryness and urinary infections […] Depression. The difficulty is that many of these are common complaints and can be attributed to life events, stress or other factors. This can lead to frustrating delays in diagnosis and also mean that not every symptom experienced is a direct result of POI. However, many women do look back after being diagnosed and realise that certain complaints probably were due to an early menopause.

• #1 Premature Ovarian Insufficiency (POI): Symptoms & Treatment

  https://www.mariongluckclinic.com/blog/premature-ovarian-insufficiency-poi-causes-symptoms-and-treatment.html

  Memory loss […] Vaginal dryness: This can result in pain during intercourse […] Recurrent thrush or atropic vaginitis: POI can cause the skin around the vulva to become thin and itchy. The bladder wall can become thinner and less elastic, causing recurrent cystitis and stress incontinence. We can treat this with vaginal estrogen and systemic estrogen such as various forms of Biodentical Hormone Replacement Therapy (BHRT).

• #1 Understanding Primary Ovarian Insufficiency (POI) | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/understanding-primary-ovarian-insufficiency-poi

  Most people with POI have had a normal puberty and normal periods. […] You may first notice your periods dont start up again after a pregnancy. Or you may be having irregular periods. Many people have irregular periods for years before being diagnosed. […] Some with POI have regular periods and no symptoms of POI. Some may have symptoms that come and go. Symptoms can include: […] Irregular periods […] No periods […] Inability to get pregnant […] Less sex drive […] Painful sex because of thinning and drying of the vagina […] Hot flashes and night sweats […] Irritability. […] These are many of the same symptoms of normal menopause.

• #1 Primary ovarian insufficiency – Wikipedia

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

  Primary ovarian insufficiency (POI), also called premature ovarian insufficiency and premature ovarian failure, is the partial or total loss of reproductive and hormonal function of the ovaries before age 40 because of follicular (egg producing area) dysfunction or early loss of eggs. POI can be seen as part of a continuum of changes leading to menopause that differ from age-appropriate menopause in the age of onset, degree of symptoms, and sporadic return to normal ovarian function. Physical and emotional symptoms are similar to those seen during menopause and can include hot flashes, night sweats, dry skin, vaginal dryness, irregular or absent menstruation, anxiety, depression, mental fog, irritability, nervousness, decreased libido, and increased autoimmune disruption. The signs and symptoms of POI can be seen as part of a continuum of changes leading to menopause. POI contrasts with age-appropriate menopause in the age of onset, degree of symptoms and sporadic return to normal ovarian function. Hormonally, POI is defined by abnormally low levels of estrogen and high levels of FSH, which demonstrate that the ovaries are no longer responding to circulating FSH by producing estrogen and developing fertile eggs. The age of onset can be as early as 11 years. The diagnosis is based on age less than 40, amenorrhea, and elevated serum follicle-stimulating hormone (FSH) levels. Typical serum FSH levels in POI patients is in the post-menopausal range. 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. Primary ovarian insufficiency is associated with co-morbidities associated with menopause including osteoporosis (decreased bone density), which affects almost all women with POI due to an insufficiency of estrogen. The most common words women use to describe how they felt in the two hours after being given the diagnosis of POI are „devastated”, „shocked,” and „confused.” The diagnosis is more than infertility and affects a woman’s physical and emotional well-being.

• #1 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment | OB-GYN Specialists of South Miami

  https://www.toplinemd.com/obgyn-specialists-of-south-miami/primary-ovarian-insufficiency-causes-symptoms-treatment/

  POI, or primary ovarian insufficiency, can be defined as a gynecologic condition that develops when a woman’s ovaries fail earlier than they should. […] Primary ovarian insufficiency happens abruptly for some women, with periods suddenly stopping. For others, the issue is progressive, following years or months of irregular periods. […] The condition causes estrogen deficiency or low estrogen levels, which may produce side effects and symptoms similar to menopause, like decreased libido, hot flashes, mood changes, and increased risk for other conditions such as heart disease and osteoporosis. […] Regarding signs and symptoms, some patients may experience nothing. Still, the most obvious signs of the condition are missed and irregular periods. Other signs may include the following: Difficulty getting pregnant, Decreased libido, Irritability, Vaginal dryness and painful intercourse, Night sweats, Hot flashes, Dry eyes, Difficulty concentrating.

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

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

  Primary ovarian insufficiency (POI), also known as primary ovarian failure or premature menopause, is a rare condition that affects teenagers and young females under the age of 40. Patients with this condition will have menstrual periods less often, or will not have menstrual periods at all for four months or more. POI affects a patients physical health, emotional health and well-being. Patients with POI have low levels of the hormone estrogen. Low estrogen may cause osteoporosis (weak bones and a higher chance of fractures) and heart disease at a younger age. […] Many females find out they have POI because their bodies are not developing as quickly as their peers. For example, they may have breast growth at a later age, and they may start their periods later. They may be shorter than their classmates, and they may not have a growth spurt until later.

• #1 How Common Is Primary Ovarian Insufficiency? Life Expectancy

  https://www.medicinenet.com/how_common_is_primary_ovarian_insufficiency/article.htm

  Primary ovarian insufficiency (POI) (also known as premature ovarian insufficiency, premature ovarian failure, or premature ovarian insufficiency syndrome) refers to when the ovaries cease to function normally before the age of 40 years. […] In contrast to the average menopausal age from 45 to 52 years, women with POI experience menopause before the age of 40 years. […] POI is thought to affect 1 in 100 women younger than 40 years, 1 in 1,000 women younger than 30 years, and 1 in 10,000 women younger than 20 years. […] POI is the loss of eggs in the ovaries or abnormal ovarian function, causing periods and the entire menstrual cycle to stop for long periods or permanently before the age of 40 years. […] POI is more common in women in their 30s than in their 20s or adolescent years.

• #1 Patient education: Primary ovarian insufficiency (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/primary-ovarian-insufficiency-beyond-the-basics/print

  Primary ovarian insufficiency (also called premature ovarian insufficiency) is a condition in which the ovaries spontaneously stop functioning normally in people who are younger than 40 years. […] When the ovaries stop working properly before age 40, doctors refer to it as primary ovarian insufficiency (POI). In most cases, is not clear why this happens. In people with POI, both of the following occur: […] Symptoms of primary ovarian insufficiency (POI) can include menstrual and hormonal changes, infertility, and emotional symptoms. […] Most people with POI go through normal puberty and have regular periods before their ovaries stop working normally. They most often seek medical attention when their period becomes irregular or infrequent. […] With POI, the ovaries eventually stop working, making it impossible to get pregnant naturally.

• #1 How Common Is Primary Ovarian Insufficiency? Life Expectancy

  https://www.medicinenet.com/how_common_is_primary_ovarian_insufficiency/article.htm

  Most of the symptoms of menopause and perimenopause overlap with those of primary ovarian insufficiency (POI). The most typical symptom for the majority of women is a gradual cessation of menstruation. […] In about 1 in 10 women with POI, the menstrual cycle may not even begin, and they first show symptoms at a very young age, typically before the age of 20 years. […] One in four affected women does not experience any POI symptoms. […] Symptoms frequently come and go; you may feel completely normal for some months and have unpleasant symptoms for other months that hurt your quality of life. […] Menstrual cycles become irregular, and for most women, they cease completely. In terms of fertility and conception, 5 to 10 percent of women may achieve a spontaneous pregnancy because its possible to sporadically ovulate with POI.

• #1 Signs and Symptoms of Primary Ovarian Insufficiency | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-319-22491-6_3

  For women diagnosed with POF/POI, the unfortunate preliminary indication is that symptoms tend to persist over time more so than symptoms of women experiencing age-appropriate menopause. […] Moreover, there may be an overall lower quality of life with time or years since diagnosis in women with POF/POI. […] For others, the condition of POF/POI is accompanied by extreme fatigue, mental fog, and depression, which limit physical function and emotional well-being. […] Despite the persistent presence of symptoms, proper management can be achieved.

• #1 Fragile X-Associated Primary Ovarian Insufficiency | FXPOI

  https://fragilex.org/understanding-fragile-x/fxpoi-primary-ovarian-insufficiency/

  Fragile X-associated primary ovarian insufficiency, one of three known Fragile X-associated disorders caused by changes in the FMR1 gene, is a condition in which the ovaries are not functioning at full capacity in an FMR1 premutation carrier. […] The ovaries in women with FXPOI do not function to full capacity and may resemble ovaries of an older woman, both in the number and quality of available eggs. […] Common symptoms of FXPOI (ovarian insufficiency) include absent or irregular cycles, sub-fertility or infertility, hot flashes, and premature ovarian failure (POF), which is the complete cessation of menstrual periods before the age of 40. In the wider range of FXPOI symptoms, premature ovarian failure is at the more severe end of the spectrum. […] FMR1 premutation carriers can have normal ovarian function, but can still go through early menopause, which is menopause occurring between 40 and 45 years of age (menopause normally occurs between 45 and 55 years old).

• #1 Premature & Early Menopause: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause

  People who go through menopause early tend to have more severe symptoms of menopause. These symptoms can lead to sexual dysfunction or loss of intimacy. […] Additionally, people who experience premature or early menopause spend more years without the benefits of estrogen. Without typical amounts of estrogen, you’re at greater risk for certain health conditions like: Osteoporosis. Heart disease. Depression. Various neurological diseases like dementia and Parkinson’s disease. […] Both early and premature menopause affect your ability to get pregnant because you’re not ovulating. However, unless you’ve gone 12 consecutive months without a menstrual period, you can still get pregnant. This is because in the years leading up to your final period, or if you have POI, there’s a chance ovulation (releasing an egg) still happens.

• #1 Understanding Premature Ovarian Insufficiency – Hertility Health

  https://hertilityhealth.com/blog/premature-ovarian-insufficiency

  Premature Ovarian Insufficiency (POI) is when the ovaries stop working normally before the age of 40. […] Symptoms can include irregular or absent periods and menopausal symptoms. […] POI symptoms are similar to menopause and low oestrogen. Youre likely to experience: Irregular periods, Hot flushes, Night sweats, Difficulty getting pregnant, Reduced sex drive, Vaginal dryness. […] Fatigue, anxiety, and depression can also be common symptoms as a result of other symptoms or a diagnosis. […] If youre missing your period for three or more months, its important to get your hormones tested to try and decipher whats going on. […] POI can reduce your fertility significantly. This can mean getting a diagnosis can be stressful and upsetting, particularly if you want to start or grow your family. […] Although POI means your ovaries arent functioning properly, as many as 25% of people with POI do spontaneously ovulate. Another 10% do conceive and deliver after their diagnosis. […] If you suspect POI symptoms, like irregular or absent periods, its important to get checked.

• #1 Primary ovarian insufficiency | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/primary-ovarian-insufficiency?content_id=CON-20208702

  Depression or anxiety. Some people with primary ovarian insufficiency become depressed or anxious. This can be due to the risk of infertility and other conditions that arise from low estrogen levels. […] Heart or blood vessel disease. Early loss of estrogen might raise the risk of heart conditions or stroke. […] Dementia. This is the term for a group of symptoms that affect memory, thinking and social skills. The dementia risk may be linked with getting both ovaries removed and not receiving estrogen therapy afterward in people under age 43. […] Treatment for primary ovarian insufficiency helps prevent these other health conditions.

• #1 Primary ovarian insufficiency – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683

  Depression or anxiety. Some people with primary ovarian insufficiency become depressed or anxious. This can be due to the risk of infertility and other conditions that arise from low estrogen levels. […] Heart or blood vessel disease. Early loss of estrogen might raise the risk of heart conditions or stroke. […] Dementia. This is the term for a group of symptoms that affect memory, thinking and social skills. The dementia risk may be linked with getting both ovaries removed and not receiving estrogen therapy afterward in people under age 43. […] Parkinson’s disease. This long-term condition affects the nervous system, which includes the brain and spinal cord. It also affects parts of the body controlled by nerves. The higher risk of Parkinson’s disease also may be linked with surgery to remove the ovaries.

• #1 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

  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. […] There is a 5-10% chance of spontaneous pregnancy despite a diagnosis of primary ovarian insufficiency. […] Primary ovarian insufficiency increases the risk of bone loss, CV disease, and endocrine disorders. […] Loss of ovarian function at an early age affects bone architecture at the very time when bone accrual is at its maximum. […] Individuals with early loss of endogenous estrogen have been shown to have an increased risk of CV mortality. […] Approximately 20% of adults with idiopathic primary ovarian insufficiency will experience hypothyroidism, most commonly Hashimoto thyroiditis. […] Patients should be tested for adrenal anti-bodies and if results are positive, should undergo yearly corticotropin stimulation testing. […] Psychologic counseling also should be offered because impaired self-esteem and emotional distress have been reported after diagnosis of primary ovarian insufficiency.

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

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

  In primary ovarian insufficiency, the ovaries stop functioning normally in women who are […] In women with occult or biochemical primary ovarian insufficiency, the only sign may be unexplained infertility. Women with overt primary ovarian insufficiency or premature ovarian failure typically have amenorrhea or irregular bleeding and often symptoms or signs of estrogen deficiency (eg, osteoporosis, atrophic vaginitis, decreased libido). They may also have changes in mood, including depression. […] Unless women with primary ovarian insufficiency receive estrogen therapy until about age 51 (the average age for menopause), the risk of osteoporosis, dementia, Parkinson disease, depression, and coronary artery disease is increased. […] If primary ovarian insufficiency is caused by an autoimmune disorder, women are at risk of potentially life-threatening primary adrenal insufficiency (Addison disease).

• #1 How Common Is Primary Ovarian Insufficiency? Life Expectancy

  https://www.medicinenet.com/how_common_is_primary_ovarian_insufficiency/article.htm

  Women with primary ovarian insufficiency (POI) have a two-year lower life expectancy than those without POI. The illness can have a negative influence on sex life, mental and cognitive health, fertility, bone health, and cardiovascular health. […] If untreated, POI is associated with a lower life expectancy, mostly owing to cardiovascular disease.

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

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

  Most women have few signs of primary ovarian insufficiency, but your health care provider may suspect the condition if you have irregular periods or are having trouble conceiving. […] Treatment for primary ovarian insufficiency focuses on the problems that arise from estrogen deficiency. […] Estrogen therapy can help prevent osteoporosis. It also can relieve hot flashes and other symptoms of low estrogen. […] The combination of hormones may make your period come back. It won’t restore your ovaries’ function. […] 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. […] If you’d hoped for future pregnancies, you might feel a deep sense of loss after you learn that you have primary ovarian insufficiency.

• #1 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/

  Women with POI should be informed that POI without HT is associated with reduced life expectancy, largely due to cardiovascular disease. […] Women with POI should be informed that POI substantially reduces the chances of natural conception. […] Women with POI should be informed that there are no interventions that have been reliably shown to increase ovarian activity and natural conception rates. […] HCPs should be aware that a diagnosis of POI can have a significant impact on psychological wellbeing and quality of life. […] The guideline group recommends offering assessment of psychological health and quality of life to all women with POI. […] HCPs should advise women that a diagnosis of POI can have a significant impact on sexual wellbeing and function. […] The guideline group recommends that HCPs routinely and sensitively ask permission of women with POI to discuss sexual wellbeing and function.

• #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. […] The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. […] 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.

• #1 Primary Ovarian Insufficiency | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/primary-ovarian-insuffiency

  Treatment depends on whether you have symptoms or are at risk for serious health problems. Hormone therapy (HT) is the most common treatment. HT combines estrogen and progesterone, another sex hormone. HT relieves menopausal symptoms and also helps prevent osteoporosis. HT can be taken as a pill or applied to your skin as a patch. Vaginal rings can also supply estrogen to the body. In older, postmenopausal women, HT may increase risk of breast cancer, heart disease, and stroke. In younger women with POI, these risks are thought to be much lower, since its normal for women in this age group to have higher estrogen levels. Usually, HT is stopped when a woman with POI reaches the age of natural menopause (around age 50). If you cannot or do not want to take HT, you might benefit from non-hormonal treatments. In addition to medical treatment, you can lower your risk of osteoporosis and heart disease by eating a healthy diet and exercising regularly.

• #1

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/primary-ovarian-insufficiency

  Most often, treatment for primary ovarian insufficiency focuses on the problems that arise from estrogen deficiency. Treatment might include: Estrogen therapy. 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. […] 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.

• #1 Premature Ovarian Insufficiency (POI) | My Menopause Centre

  https://www.mymenopausecentre.com/knowledge/premature-ovarian-insufficiency-poi-2/

  Your ovaries produce a number of hormones including the hormone oestrogen. When the ovaries slow down, the levels of oestrogen decrease, resulting in symptoms of the menopause. Periods become very infrequent or stop. There are also other long-term health consequences. […] The symptoms are the same as for any woman transitioning through the menopause for example, hot flushes, cognitive impairment, difficulties with low mood, depression or anxiety. […] Some women dont have symptoms apart from irregular periods or periods stopping. Sometimes the diagnosis is made during investigations when a woman is having difficulties getting pregnant. […] Its so important to make the diagnosis of POI, so you can start hormone replacement therapy to treat the symptoms and reduce the risk of long-term health consequences (see below). […] Many women dont realise that, if left untreated that is if the oestrogen that is lost is not replaced the risk of heart disease and osteoporosis increases significantly, to the extent that life expectancy can decrease. The good news is that taking HRT reduces these risks.

• #1 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

  Therefore, in young females it is important to evaluate amenorrhea or a change from regular to irregular menses for 3 or more consecutive months in the absence of hormonal preparations such as oral contraceptives (OCs) for all potential causes, including pregnancy, polycystic ovary syndrome, hypothalamic amenorrhea, thyroid abnormalities, hyperprolactinemia, and primary ovarian insufficiency. […] Once primary ovarian insufficiency is diagnosed, patients should be evaluated at least annually. […] The goals of hormonal therapy extend beyond simply symptom relief to levels that support bone, cardiovascular, and sexual health. […] Patients with primary ovarian insufficiency are estrogen deficient. […] 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.

• #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

  Women with primary ovarian insufficiency may experience hot flushes, night sweats, vaginal dryness, dyspareunia, and disordered sleep; some symptoms may develop before cycle irregularity. […] Regardless of the underlying cause of primary ovarian insufficiency, the consequences of ovarian dysfunction and hypoestrogenism can be dire for affected individuals. […] The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. […] Women with primary ovarian insufficiency may experience hot flushes, night sweats, vaginal dryness, dyspareunia, and disordered sleep; some symptoms may develop before cycle irregularity. […] Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years).

• #1 Primary Ovarian Insufficiency (POI) – Center for Young Women’s Health

  https://youngwomenshealth.org/guides/primary-ovarian-insufficiency/

  Young people with POI stop having periods early or have very irregular periods. […] People with POI may have one or more of the following symptoms: Lack of menstrual periods or irregular periods. […] The most common symptom is a lack of menstrual periods. […] POI can be unpredictable, but it is usually permanent, especially if the ovaries haven’t worked for a long time or if there is an identified reason for POI. […] When you begin hormone replacement therapy, your breasts may feel a little sore and increase in size (if they have not finished growing). You may also start having menstrual periods, cramps, and even PMS symptoms such as mood swings, just like you would if your body was making progesterone and estrogen normally.

• #1

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

  The likelihood of natural conception in women with primary ovarian insufficiency is 1-5% over a lifetime. […] Hormone treatment, either with MHT or a COC, is recommended for women with primary ovarian insufficiency (unless there are contraindications) to alleviate symptoms, improve their quality of life, and reduce the long-term risks of oestrogen deficiency. […] Women with primary ovarian insufficiency should be reviewed at least annually, including an assessment of symptom control, adherence to treatment and cardiovascular risk.

• #1 Premature ovarian insufficiency – British Menopause Society

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

  Premature ovarian insufficiency […] Women with POI are at increased risk of cardiovascular disease, osteoporosis and cognitive impairment. […] Women with POI can have intermittent ovarian activity and have a chance of natural conception estimated to be in the region of 5-10%. […] Fertility preservation techniques including oocyte / embryo cryopreservation or ovarian tissue cryopreservation are unlikely to be successful in women with established POI. […] Observational data have shown that women with POI have a lower risk of breast cancer compared with controls. […] There is limited evidence on the risk of VTE in women with POI or that associated with the use of sex steroid hormone replacement in this group of women.

• #1

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

  Primary ovarian insufficiency is the loss of ovarian function before age 40 years, resulting in menstrual irregularities and menopausal symptoms. Hormone treatment until the age of natural menopause is recommended to alleviate symptoms and reduce the long-term risks of oestrogen deficiency, such as fracture and cardiovascular disease. […] Primary ovarian insufficiency can be diagnosed in women aged 40 years with four to six months of amenorrhoea (after excluding other causes) and two FSH tests 40 IU/L, at least four weeks apart. […] Women with primary ovarian insufficiency typically present to primary care with menstrual irregularities, infertility or menopausal symptoms (e.g. hot flushes, mood changes, sleep disturbance, urogenital atrophy, altered libido). […] Primary ovarian insufficiency can have a significant effect on a woman’s life plans (e.g. if she wishes to have biological children) and sense of identity; depression and anxiety are common.

• #2 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. […] The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. […] 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.

• #2 Primary ovarian insufficiency – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/syc-20354683

  Symptoms of primary ovarian insufficiency are like those of menopause or low estrogen. They include: […] Irregular or missed periods. This symptom might be present for years. It also could develop after a pregnancy or after stopping birth control pills. […] Trouble getting pregnant. […] Hot flashes and night sweats. […] Vaginal dryness. […] Anger, depression or anxiety. […] Trouble with focus or memory. […] Less sexual desire. […] Primary ovarian insufficiency can lead to other health conditions, including the following: […] Infertility. Not being able to get pregnant can be a complication of primary ovarian insufficiency. Rarely, pregnancy is possible until the body’s supply of eggs runs out. […] Osteoporosis. This condition causes bones to become weak, brittle and more likely to break. Women with low levels of the hormone estrogen have a higher risk of getting osteoporosis. That’s because estrogen helps keep bones strong.

• #2 Primary Ovarian Insufficiency | POI | MedlinePlus

  https://medlineplus.gov/primaryovarianinsufficiency.html

  Primary ovarian insufficiency (POI), also known as premature ovarian failure, happens when a woman’s ovaries stop working normally before she is 40. […] The first sign of POI is usually irregular or missed periods. Later symptoms may be similar to those of natural menopause: Hot flashes, Night sweats, Irritability, Poor concentration, Decreased sex drive, Pain during sex, Vaginal dryness. […] For many women with POI, trouble getting pregnant or infertility is the reason they go to their health care provider.

• #2 Primary Ovarian Insufficiency – Women’s Health – Associates for Women’s Medicine – Syracuse NY Gynecologist, Gynecology, Obstetrics, OBGYN, OB Physicians, Syracuse New York, Fayetteville, North Syracuse, LiverpoolPrimary Ovarian Insufficiency

  https://www.afwomensmed.com/health-library/hw-view.php?DOCHWID=uf6200spec

  Primary ovarian insufficiency may develop as early as the teen years, or the problem may have been present from birth. […] The symptoms of primary ovarian insufficiency are similar to those of menopause. Your menstrual periods may become irregular—you have a period one month but not the next—or they may stop. You also may have some or all of the symptoms of menopause, such as hot flashes, night sweats, irritability, vaginal dryness, low sex drive, or trouble sleeping. […] Symptoms can also include fertility problems. It may be more difficult, though not impossible, to become pregnant.

• #2 Primary ovarian insufficiency | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/primary-ovarian-insufficiency?content_id=CON-20208702

  Symptoms of primary ovarian insufficiency are like those of menopause or low estrogen. They include: […] Irregular or missed periods. This symptom might be present for years. It also could develop after a pregnancy or after stopping birth control pills. […] Trouble getting pregnant. […] Hot flashes and night sweats. […] Vaginal dryness. […] Anger, depression or anxiety. […] Trouble with focus or memory. […] Less sexual desire. […] Primary ovarian insufficiency can lead to other health conditions, including the following: […] Infertility. Not being able to get pregnant can be a complication of primary ovarian insufficiency. Rarely, pregnancy is possible until the body’s supply of eggs runs out. […] Osteoporosis. This condition causes bones to become weak, brittle and more likely to break. Women with low levels of the hormone estrogen have a higher risk of getting osteoporosis. That’s because estrogen helps keep bones strong.

• #2

• #2 Signs and Symptoms of Premature Ovarian Insufficiency

  https://www.daisynetwork.org/about-poi/signs-and-symptoms/

  The following symptoms can all be indicators that you may be entering or experiencing POI: Irregular periods or periods stopping this is the most common reason for recognising that something is not right […] Infertility […] Hot flushes and night sweats […] Insomnia/disrupted sleep […] Palpitations […] Weight gain (especially around waist and abdomen) […] Skin and hair changes (dryness, thinning) […] Headaches […] Breast tenderness […] Mood swings and irritability […] Anxiety/panic attacks […] Loss of self-esteem […] Lowered libido […] Difficulty concentrating and memory lapses […] Fatigue/low energy levels […] Joint/muscle pain […] Vaginal dryness and urinary infections […] Depression. The difficulty is that many of these are common complaints and can be attributed to life events, stress or other factors. This can lead to frustrating delays in diagnosis and also mean that not every symptom experienced is a direct result of POI. However, many women do look back after being diagnosed and realise that certain complaints probably were due to an early menopause.

• #2 Primary ovarian insufficiency | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/primary-ovarian-insufficiency?content_id=CON-20208702

  Depression or anxiety. Some people with primary ovarian insufficiency become depressed or anxious. This can be due to the risk of infertility and other conditions that arise from low estrogen levels. […] Heart or blood vessel disease. Early loss of estrogen might raise the risk of heart conditions or stroke. […] Dementia. This is the term for a group of symptoms that affect memory, thinking and social skills. The dementia risk may be linked with getting both ovaries removed and not receiving estrogen therapy afterward in people under age 43. […] Treatment for primary ovarian insufficiency helps prevent these other health conditions.

• #2 Signs and Symptoms of Primary Ovarian Insufficiency | Obgyn Key

  https://obgynkey.com/signs-and-symptoms-of-primary-ovarian-insufficiency/

  In our cohort, 46 % of women reported currently experiencing hot flushes, 40 % experience night sweats, and 34 % reported sweating. […] Women who experienced more severe symptoms demonstrated lower levels of mindfulness as measured by the CAMS-R in each domain and overall. Additionally, women reporting mental fog in the past 30 days reported lower levels of mindfulness than women not reporting mental fog. […] A history of depression is highly prevalent among women with POF/POI, as demonstrated by our cohort where 43 % of women reported a history including a diagnosis of depression. The association between POF/POI and depression has been suggested to be overlapping pathophysiology or bidirectional in our cohort, as opposed to causal.

• #2 Patient education: Primary ovarian insufficiency (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/primary-ovarian-insufficiency-beyond-the-basics/print

  Because the body eventually produces little or no estrogen, people with POI can also have symptoms of menopause, like hot flashes, night sweats, and sleep disturbances. […] It can be very upsetting to learn that you have POI, especially if you were planning to get pregnant in the future. It is normal to feel sad or stressed. Some people develop symptoms of depression or anxiety. […] Even if you do not want to get pregnant, primary ovarian insufficiency (POI) can affect your overall health. […] If blood tests confirm that you have POI, your health care provider should then look for a potential cause. […] Being diagnosed with primary ovarian insufficiency (POI) can affect both your physical and emotional well-being. […] One of the main goals of POI treatment is replacing the estrogen that the ovaries have stopped producing. […] People with POI often experience intermittent ovarian function and occasional ovulation. This means pregnancy is unlikely but possible. […] Between 5 and 10 percent of people with POI are able to conceive and carry a pregnancy without any special treatment.

• #2 Symptoms of premature ovarian failure and what can cause it

  https://thefertilitycentermexico.com/en/blog/main-symptoms-of-premature-ovarian-failure-and-what-can-cause-it/

  Main symptoms of premature ovarian failure and what can cause it […] When an abnormality in ovarian function occurs, the first symptom will be the alteration of the menstrual period. Ovulatory dysfunction can cause an increase or decrease in estrogen, which translates into irregular menstrual periods or the complete absence of them before reaching the age of 40. […] Other symptoms are very similar to those that occur during menstruation, such as increased sweating (especially at night), a feeling of flushing, irritability, vaginal dryness, pain during sexual intercourse, and a significant decrease in sexual desire. These are due to variations in estrogen, and can be accompanied by insomnia, irritability, mood swings, lack of concentration and even anxiety and depression. […] Some women with FOP have eye disorders such as dry eye syndrome, ocular surface disease, which can cause blurred vision, discomfort, and permanent eye damage if left untreated.

• #2 Premature Ovarian Insufficiency (POI): Symptoms & Treatment

  https://www.mariongluckclinic.com/blog/premature-ovarian-insufficiency-poi-causes-symptoms-and-treatment.html

  For many women, the most common symptom of POI is the cessation of regular periods. However, there are several symptoms that some women experience in addition to this: […] Hot flushes: These can occur suddenly and are associated with sweating and dizziness […] Insomnia […] Low libido: Hormone levels, in particular androgens such as testosterone, fall lower than they do during normal menopause, which greatly impacts libido […] Loss of concentration and focus […] Joint pain: Falling estrogen levels means a lack of the hormones natural anti-inflammatory and lubricating properties for the joints […] Changes to the hair and skin: Falling estrogen levels also impact collagen and hair growth […] Depression and anxiety: These symptoms are much worse with POI due to severe hormone fluctuations. In addition, the diagnosis itself can cause low self-esteem and inadequacy especially concerning future fertility

• #2 Ovarian Insufficiency Clinical Presentation: History, Physical Examination

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

  Ovarian insufficiency comprises a continuum along a decline in ovarian function. […] Patients with ovarian insufficiency frequently produce estrogen intermittently and may not demonstrate physical findings of estrogen deficiency. […] Bimanual examination may reveal ovarian enlargement in patients who have lymphocytic oophoritis or steroidogenic enzyme defects. […] Autoimmune disorders known to be associated with POI have the following characteristic physical findings that should be elicited: Changes in pigmentation, such as premature gray hair, may be associated with autoimmune hypothyroidism. […] Vitiligo or increased pigmentation of the gums or the skin folds may herald Addison disease. […] Patients with Addison disease also may experience a loss of axillary and pubic hair because of reduced ovarian and adrenal androgen production.

• #2 Fragile X-Associated Primary Ovarian Insufficiency | FXPOI

  https://fragilex.org/understanding-fragile-x/fxpoi-primary-ovarian-insufficiency/

  Even though women with FXPOI may develop symptoms similar to those of menopause, such as hot flashes and vaginal dryness, FXPOI differs from menopause in some important ways: […] If you are concerned that you might have FXPOI, talk to your physician about having your FSH, a hormone that reflects ovarian function, measured. FSH levels increase as you approach menopause or if your ovaries are not functioning properly for your age.

• #2 Primary Ovarian Insufficiency: Causes, Symptoms & Treatment | OB-GYN Specialists of South Miami

  https://www.toplinemd.com/obgyn-specialists-of-south-miami/primary-ovarian-insufficiency-causes-symptoms-treatment/

  POI, or primary ovarian insufficiency, can be defined as a gynecologic condition that develops when a woman’s ovaries fail earlier than they should. […] Primary ovarian insufficiency happens abruptly for some women, with periods suddenly stopping. For others, the issue is progressive, following years or months of irregular periods. […] The condition causes estrogen deficiency or low estrogen levels, which may produce side effects and symptoms similar to menopause, like decreased libido, hot flashes, mood changes, and increased risk for other conditions such as heart disease and osteoporosis. […] Regarding signs and symptoms, some patients may experience nothing. Still, the most obvious signs of the condition are missed and irregular periods. Other signs may include the following: Difficulty getting pregnant, Decreased libido, Irritability, Vaginal dryness and painful intercourse, Night sweats, Hot flashes, Dry eyes, Difficulty concentrating.

• #2 Patient education: Primary ovarian insufficiency (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/primary-ovarian-insufficiency-beyond-the-basics

  Symptoms of primary ovarian insufficiency (POI) can include menstrual and hormonal changes, infertility, and emotional symptoms. […] Most people with POI go through normal puberty and have regular periods before their ovaries stop working normally. They most often seek medical attention when their period becomes irregular or infrequent. […] With POI, the ovaries eventually stop working, making it impossible to get pregnant naturally. […] Because the body eventually produces little or no estrogen, people with POI can also have symptoms of menopause, like hot flashes, night sweats, and sleep disturbances. […] It can be very upsetting to learn that you have POI, especially if you were planning to get pregnant in the future. It is normal to feel sad or stressed. Some people develop symptoms of depression or anxiety.

• #2 Premature ovarian insufficiency | Endocrine Conditions

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

  Menopause usually happens in women over the age of 45 years, but if the ovaries stop working prematurely (i.e. before the age of 40 years), this is called Premature Ovarian Insufficiency (POI). […] Premature ovarian insufficiency (POI) is a condition in which the ovaries run out of eggs and stop producing hormones, such that periods stop unusually early (i.e., before the age of 40 years). […] The cessation of menstrual periods is the commonest symptom, and can be associated with other symptoms that can occur during menopause such as hot flushes, sweats, sleep disturbance and mood changes. […] Premature ovarian insufficiency (POI) means that the ovaries are not functioning well, and therefore the chance of conceiving is much reduced. However, the function of the ovaries can wax and wane during the early years after diagnosis of POI, more so than after the natural menopause, such that spontaneous pregnancy can still occur even after the diagnosis of POI. […] 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.

• #2 To Patients with Premature Ovarian Failure

  https://rscbayarea.com/article/premature-ovarian-failure/

  Premature ovarian failure, also known as premature ovarian insufficiency (POI), occurs when the ovaries stop functioning normally before the age of 40. Unlike natural menopause, where the decline in ovarian function occurs gradually, POI is characterized by a sudden and unexpected loss of ovarian activity. […] Recognizing the symptoms of premature ovarian failure is crucial for early detection and management. Some common signs include irregular or absent periods, hot flashes, vaginal dryness, mood swings, decreased sexual desire, and difficulties with concentration or memory. […] Diagnosing POI involves a combination of medical history, physical examination, hormone level measurements (such as FSH and estradiol), and possibly an ultrasound to assess ovarian reserve. […] While POI is associated with diminished ovarian function and reduced fertility, spontaneous pregnancies can still occur in some cases. Approximately 5%-10% of women with POI may experience occasional spontaneous ovulation and conceive naturally, especially within a few years of the diagnosis.

• #2 Primary Ovarian Insufficiency (POI) – Center for Young Women’s Health

  https://youngwomenshealth.org/guides/primary-ovarian-insufficiency/

  Young people with POI stop having periods early or have very irregular periods. […] People with POI may have one or more of the following symptoms: Lack of menstrual periods or irregular periods. […] The most common symptom is a lack of menstrual periods. […] POI can be unpredictable, but it is usually permanent, especially if the ovaries haven’t worked for a long time or if there is an identified reason for POI. […] When you begin hormone replacement therapy, your breasts may feel a little sore and increase in size (if they have not finished growing). You may also start having menstrual periods, cramps, and even PMS symptoms such as mood swings, just like you would if your body was making progesterone and estrogen normally.

• #2 Premature & Early Menopause: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause

  People who go through menopause early tend to have more severe symptoms of menopause. These symptoms can lead to sexual dysfunction or loss of intimacy. […] Additionally, people who experience premature or early menopause spend more years without the benefits of estrogen. Without typical amounts of estrogen, you’re at greater risk for certain health conditions like: Osteoporosis. Heart disease. Depression. Various neurological diseases like dementia and Parkinson’s disease. […] Both early and premature menopause affect your ability to get pregnant because you’re not ovulating. However, unless you’ve gone 12 consecutive months without a menstrual period, you can still get pregnant. This is because in the years leading up to your final period, or if you have POI, there’s a chance ovulation (releasing an egg) still happens.

• #2 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

  Osteoporosis is considered one of the most feared consequences by patients with POI. The prevalence of osteoporosis is estimated to be 8-14% in women with POI, and bone loss of up to 26% at the lumbar spine, compared with a control population, has been reported. […] Women with POI are at risk of premature mortality, largely due to CVD, and may be worsened by the presence of other modifiable CVD risk factors.

• #2 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

  Menopausal symptoms (eg hot flushes and urogynaecological and sexual changes) may be more severe in women with premature menopause, compared with natural menopause, whereas women with primary amenorrhoea are unlikely to experience menopausal symptoms. […] Infertility is a key feature of POI given the loss of ovarian reserve. […] Women with POI may present with adverse psychosocial symptoms, and have been found to have higher levels of depression and anxiety, a more negative body image, decreased sexual function and reduced confidence, compared with premenopausal controls. […] Women with POI are at risk of complications relating to the underlying cause of POI, such as breast cancer recurrence or complications of Turner syndrome, but are also at risk of developing long-term consequences from POI itself. The key long-term consequences are shown in Figure 1 and summarised below. POI is an independent risk factor for CVD, with increased premature coronary artery disease and CVD mortality.

• #2 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/

  HCPs and women should be aware that POI is associated with an increased risk of cognitive impairment and dementia. […] The possible detrimental effect on cognition and increased risk of dementia, parkinsonism, and other neurologic diseases should be discussed when planning bilateral oophorectomy under the age of 45 years, especially for women at an average risk of ovarian cancer.

• #2 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/

  Women with POI should be informed that POI without HT is associated with reduced life expectancy, largely due to cardiovascular disease. […] Women with POI should be informed that POI substantially reduces the chances of natural conception. […] Women with POI should be informed that there are no interventions that have been reliably shown to increase ovarian activity and natural conception rates. […] HCPs should be aware that a diagnosis of POI can have a significant impact on psychological wellbeing and quality of life. […] The guideline group recommends offering assessment of psychological health and quality of life to all women with POI. […] HCPs should advise women that a diagnosis of POI can have a significant impact on sexual wellbeing and function. […] The guideline group recommends that HCPs routinely and sensitively ask permission of women with POI to discuss sexual wellbeing and function.

• #2 Premature Ovarian Insufficiency (POI) | My Menopause Centre

  https://www.mymenopausecentre.com/knowledge/premature-ovarian-insufficiency-poi-2/

  Your ovaries produce a number of hormones including the hormone oestrogen. When the ovaries slow down, the levels of oestrogen decrease, resulting in symptoms of the menopause. Periods become very infrequent or stop. There are also other long-term health consequences. […] The symptoms are the same as for any woman transitioning through the menopause for example, hot flushes, cognitive impairment, difficulties with low mood, depression or anxiety. […] Some women dont have symptoms apart from irregular periods or periods stopping. Sometimes the diagnosis is made during investigations when a woman is having difficulties getting pregnant. […] Its so important to make the diagnosis of POI, so you can start hormone replacement therapy to treat the symptoms and reduce the risk of long-term health consequences (see below). […] Many women dont realise that, if left untreated that is if the oestrogen that is lost is not replaced the risk of heart disease and osteoporosis increases significantly, to the extent that life expectancy can decrease. The good news is that taking HRT reduces these risks.

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

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

  Primary ovarian insufficiency causes low estrogen levels. Losing estrogen can have side effects similar to those that occur with menopause, such as hot flashes, decreased sex drive and mood changes. It also increases your risk for osteoporosis, heart disease and other conditions. […] The most common sign of POI is irregular or missed periods. Some women with primary ovarian insufficiency dont have any noticeable symptoms. Other symptoms can include: Irregular or missed periods. Trouble getting pregnant. Decreased sex drive. Difficulty concentrating. Irritability. Dry eyes. Hot flashes and night sweats. Vaginal dryness. Painful sex due to vaginal dryness. […] Primary ovarian insufficiency is usually permanent. Most women with the condition take long-term hormone therapy to manage symptoms and reduce the risk of complications. […] Primary ovarian insufficiency often causes feelings of sadness and loss, especially if you still had hopes for getting pregnant. Support groups and counseling are available. These supports can help you manage emotions and find ways to cope.

• #2 Primary Ovarian Insufficiency

  https://www.myactivehealth.com/hwcontent/content/special/uf6200spec.html

  A woman who has primary ovarian insufficiency is very likely to have irregular or no periods, infertility problems, and menopause-like symptoms. […] The symptoms of primary ovarian insufficiency are similar to those of menopause. Your menstrual periods may become irregular-you have a period one month but not the next-or they may stop. You also may have some or all of the symptoms of menopause, such as hot flashes, night sweats, irritability, vaginal dryness, low sex drive, or trouble sleeping. […] If the amount of FSH in your blood is higher than normal on more than one day, you may have primary ovarian insufficiency. Another blood test also may be done to measure the amount of estradiol (or estrogen) in your blood. Very low estrogen with a high FSH is a sign of primary ovarian insufficiency. […] 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.

• #2 Primary Ovarian Insufficiency | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/primary-ovarian-insuffiency

  Treatment depends on whether you have symptoms or are at risk for serious health problems. Hormone therapy (HT) is the most common treatment. HT combines estrogen and progesterone, another sex hormone. HT relieves menopausal symptoms and also helps prevent osteoporosis. HT can be taken as a pill or applied to your skin as a patch. Vaginal rings can also supply estrogen to the body. In older, postmenopausal women, HT may increase risk of breast cancer, heart disease, and stroke. In younger women with POI, these risks are thought to be much lower, since its normal for women in this age group to have higher estrogen levels. Usually, HT is stopped when a woman with POI reaches the age of natural menopause (around age 50). If you cannot or do not want to take HT, you might benefit from non-hormonal treatments. In addition to medical treatment, you can lower your risk of osteoporosis and heart disease by eating a healthy diet and exercising regularly.

• #2

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/primary-ovarian-insufficiency

  Most often, treatment for primary ovarian insufficiency focuses on the problems that arise from estrogen deficiency. Treatment might include: Estrogen therapy. 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. […] 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.

• #2

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

  Women with primary ovarian insufficiency may experience hot flushes, night sweats, vaginal dryness, dyspareunia, and disordered sleep; some symptoms may develop before cycle irregularity. […] Regardless of the underlying cause of primary ovarian insufficiency, the consequences of ovarian dysfunction and hypoestrogenism can be dire for affected individuals. […] The results from the Womens Health Initiative trials related to menopause therapy are not applicable to young women with primary ovarian insufficiency whose exposure to physiologic estrogen has been withdrawn prematurely. […] 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 – Fertility Answers – Louisiana Fertility

  https://www.fertilityanswers.com/female-infertility/primary-ovarian-insufficiency/

  Primary ovarian insufficiency, or POI, occurs when the ovaries stop functioning normally before age 40. When this happens, your ovaries don’t produce normal amounts of the hormone estrogen or release eggs regularly. This condition was formerly known as “premature ovarian failure.” […] In general, early loss of ovarian function is a gradual process. Early on in this process POI may only demonstrate a few symptoms. Ultimately this process results in premature menopause where women stop having periods and cannot become pregnant. […] Signs and symptoms of primary ovarian insufficiency are similar to those of menopause or estrogen deficiency. They include: Irregular or skipped periods for three months or more, Absent periods for more than a year, Hot flashes and/or night sweats, Signs of estrogen deficiency, including osteoporosis, decreased libido, and vaginal dryness, Irritability, depression or difficulty concentrating. […] If you’ve missed your period for three months or more, it might be time to see your gynecologist or a reproductive endocrinologist to determine the cause. […] No treatment has been proved to increase the ovulation rate or restore fertility in women with primary ovarian insufficiency.

• #2 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

  ABSTRACT: Primary ovarian insufficiency is the depletion or dysfunction of ovarian follicles with cessation of menses before age 40 years. […] There is no consensus on criteria to identify primary ovarian insufficiency in adolescents, and delay in diagnosis is common. […] Although some adolescent females will report hot flushes or vaginal symptoms like dryness or dyspareunia, the most common presenting symptom of primary ovarian insufficiency is primary or secondary amenorrhea. […] Among patients with amenorrhea, the incidence of primary ovarian insufficiency ranges from 2% to 10%. […] Because irregular menstrual cycles are both common during early adolescence and an initial symptom of early primary ovarian insufficiency, diagnosis can be difficult in this population. […] Although less than 10% of women who present with abnormal menses will ultimately be found to have primary ovarian insufficiency, the condition has such detrimental consequences on bone health that early diagnosis of this condition is important.

• #2 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

  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. […] There is a 5-10% chance of spontaneous pregnancy despite a diagnosis of primary ovarian insufficiency. […] Primary ovarian insufficiency increases the risk of bone loss, CV disease, and endocrine disorders. […] Loss of ovarian function at an early age affects bone architecture at the very time when bone accrual is at its maximum. […] Individuals with early loss of endogenous estrogen have been shown to have an increased risk of CV mortality. […] Approximately 20% of adults with idiopathic primary ovarian insufficiency will experience hypothyroidism, most commonly Hashimoto thyroiditis. […] Patients should be tested for adrenal anti-bodies and if results are positive, should undergo yearly corticotropin stimulation testing. […] Psychologic counseling also should be offered because impaired self-esteem and emotional distress have been reported after diagnosis of primary ovarian insufficiency.

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

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

  Premature ovarian insufficiency is sometimes called premature ovarian failure. The condition occurs when your ovaries no longer work properly when you are under the age of 40 years. Your ovaries no longer produce normal amounts of oestrogen and therefore may not produce eggs. This means that your periods stop (or become irregular) and you may experience symptoms of the menopause. With premature ovarian insufficiency your ovaries are not working properly and have stopped producing eggs early. In some women, however, this loss of function is temporary and their ovaries work and function again in the future. This means that you may find that your periods return at some stage in the future. Therefore premature ovarian insufficiency is not necessarily the same as premature menopause, which means the irreversible loss of ovarian function before the age of 40 years. For most women, the most common symptom is that their periods stop. For around 1 in 10 women with premature ovarian insufficiency (POI), their periods do not start and they present with POI at a very early age, usually under 20 years. Other women may notice that their periods become irregular. Many women experience symptoms of the menopause. These include hot flushes, night sweats, reduced energy, mood disturbances, loss of energy and loss of sex drive. Some women notice that their hair becomes thinner and they have some joint pains. However, around 1 in 4 women do not have any of these symptoms. It can be very common to feel anxious, be worried or even have feelings of hopelessness after a diagnosis of POI has been made. Some women find they feel very sad and even guilty, as having POI affects fertility. The low level of oestrogen in your body can lead to 'thinning’ of the bones (osteoporosis) developing which can then lead to fractures developing in your bones. There is also an increased risk of heart attacks at a young age. However, these increased risks are all reversed by taking hormone treatment. 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.

• #2 Primary ovarian insufficiency – Wikipedia

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

  Primary ovarian insufficiency (POI), also called premature ovarian insufficiency and premature ovarian failure, is the partial or total loss of reproductive and hormonal function of the ovaries before age 40 because of follicular (egg producing area) dysfunction or early loss of eggs. POI can be seen as part of a continuum of changes leading to menopause that differ from age-appropriate menopause in the age of onset, degree of symptoms, and sporadic return to normal ovarian function. Physical and emotional symptoms are similar to those seen during menopause and can include hot flashes, night sweats, dry skin, vaginal dryness, irregular or absent menstruation, anxiety, depression, mental fog, irritability, nervousness, decreased libido, and increased autoimmune disruption. The signs and symptoms of POI can be seen as part of a continuum of changes leading to menopause. POI contrasts with age-appropriate menopause in the age of onset, degree of symptoms and sporadic return to normal ovarian function. Hormonally, POI is defined by abnormally low levels of estrogen and high levels of FSH, which demonstrate that the ovaries are no longer responding to circulating FSH by producing estrogen and developing fertile eggs. The age of onset can be as early as 11 years. The diagnosis is based on age less than 40, amenorrhea, and elevated serum follicle-stimulating hormone (FSH) levels. Typical serum FSH levels in POI patients is in the post-menopausal range. 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. Primary ovarian insufficiency is associated with co-morbidities associated with menopause including osteoporosis (decreased bone density), which affects almost all women with POI due to an insufficiency of estrogen. The most common words women use to describe how they felt in the two hours after being given the diagnosis of POI are „devastated”, „shocked,” and „confused.” The diagnosis is more than infertility and affects a woman’s physical and emotional well-being.

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