Premature Ovarian insufficiency

What is premature ovarian insufficiency?

Premature ovarian insufficiency or POI, is when the ovaries stop functioning properly under the age of 40.

What causes POI?

Idiopathic POI is when no cause has yet to be found for why someone has developed POI. This Is the most common reason for most women.

It is thought, however, that genetics plays a role in the development of POI . It is associated with some genetic conditions such as Turner’s Syndrome and carriers of the FMR 1 gene mutation ( fragile X).

Other causes can include autoimmune disease, iatrogenic causes ( such as chemotherapy, radiotherapy, medication induced, and surgical removal of the ovaries), and rarely infection..

Removal of ovaries before 40 years of age will always induce POI. This surgery is sometimes done as a preventative measures for those with a confirmed genetic predisposition to certain types of cancer.

How is POI diagnosed?

The diagnosis criteria is as follows:

Under the age of 40
FSH blood test >30 on two occasions at least 4 weeks apart.
Oligomenorrhea (irregular/infrequent periods) or amenorrhea (absence of period) for at least 4 months.

What does this mean for my health?

POI can have an impact on your overall health. Being diagnosed with POI can affect fertility, bone, heart, and brain health as sex hormones play an important role in these areas of the body, especially when loss of these hormones occur at a younger age. A reduction in oestrogen levels can affect your overall health and cause menopausal symptoms such as hot flushes, night sweats, loss of libido etc.

Are there treatment options?

POI is usually treated with hormone replacement therapy (HRT). HRT aims to bring the hormonal environment back in line with women of a similar age. HRT does not increase the risk of breast cancer in women with POI and any increased risk is thought to occur from the age of 50/51 onwards which is the average age of menopause. There are different routes, regimes, and products that your doctor will discuss with you. The majority of women with POI will be able to take HRT unless they have an active contraindication such as a hormone sensitive cancer.

Useful websites

https://www.wellnesswarrior.ie/the-daisy-network

https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Management-of-premature-ovarian-insufficiency