Understanding loss of ovarian function before age 40 and why hormone replacement is essential for long-term health
Premature Ovarian Insufficiency (POI), previously called "premature ovarian failure" or "premature menopause," is loss of ovarian function before age 40. POI affects approximately 1% of women under 40 and 5% of women ages 40-45 (early menopause).
In POI, the ovaries stop functioning normally before the natural age of menopause (average 51-52 years). This means lower estrogen production, irregular or absent periods, and difficulty conceiving.
POI has significant implications for both immediate quality of life and long-term health:
Hormone replacement therapy (HRT) is strongly recommended to replace hormones to physiologic premenopausal levels until the natural age of menopause, protecting bone, cardiovascular, and cognitive health.
POI is diagnosed when ALL of the following are present:
Symptoms are the same as perimenopause and menopause, but occurring decades earlier:
50-90% of POI cases have no identifiable cause despite thorough workup. This is called idiopathic POI.
When POI is suspected (young woman with irregular periods, hot flashes, or fertility concerns), a thorough workup is performed to confirm diagnosis and identify potential causes.
Repeat testing in 1 month to confirm diagnosis:
Hormone replacement therapy (HRT) addresses these risks and is strongly recommended.
Management focuses on hormone replacement, bone and cardiovascular health, fertility considerations, and psychosocial support. This is educational information only - treatment decisions should be made with your healthcare provider.
Primary treatment for POI. HRT replaces hormones to physiologic premenopausal levels, not the lower doses used for postmenopausal women.
This educational content cannot and does not:
POI requires specialized, multidisciplinary care with individualized treatment based on your age, symptoms, fertility desires, and health history.
POI causes the same symptoms as natural menopause, just decades earlier
Scripts for requesting hormone testing when symptoms are dismissed
Understanding FSH, estradiol, and hormone testing
Evidence-based nutrition for bone and cardiovascular health