What is Premature Ovarian Insufficiency?
Premature Ovarian Insufficiency (POI) occurs when a woman’s ovaries run out of eggs before the age of 40 years. It is also referred to as premature menopause or premature ovarian failure but POI is the preferred term.
If you are aged under 40 years old and notice your periods are becoming irregular or have stopped, it this may be a symptom of POI.
What causes POI?
For many women, the cause of POI is not found. Recognised causes include:
- Genetic – there may be a family history;
- Infective – for example, history of mumps;
- Autoimmune disease – often associated with adrenal or thyroid conditions; or
- Medical or surgical treatments – for example chemo/radiotherapy.
How common is POI?
According to the Daisy Network, a leading UK charity supporting women with POI, approximately one in every 100 women under the age of 40, one in 1,000 women under 30 and one in 10,000 under 20 experience POI.
Did you know…
The number of women with POI appears to be higher than original estimates – recent surveys suggest that the number may be as high as 3 to 4 in 100 in some countries.
What is the impact of POI on health and well-being?
Although not impossible, POI significantly reduces the chances of achieving a pregnancy with your own eggs. If left untreated, POI can also reduce physical and emotional quality of life and in the long term it can affect the health of the bones, heart and brain.
A diagnosis of POI may impact your emotional well-being, so it could be helpful to contact a mental health professional or support group.
How is POI diagnosed?
The most common way to diagnose is a blood test that measures your level of follicle-stimulating hormone (FSH).
Your doctor will ask about your family history and perform blood tests (repeated four to six weeks apart) to measure the level of follicle-stimulating hormone (FSH) and estrogen levels. High FSH levels and low estrogen levels mean that it is likely that you are experiencing POI. An anti-mullerian hormone (AMH) test may also be required where there is diagnostic uncertainty.
What are the treatment options?
It is important to prioritise a healthy diet, regular exercise and emotional well-being. Symptoms can be successfully treated with hormone therapy, either with:
Natural hormones which mimic your own body’s ovarian hormones, such as estrogen/progesterone/testosterone or the combined oral contraceptive pill.
It is important that hormones are replaced at least until the average age of the natural menopause (51 years).
Note: Fertility treatment options will vary globally due to cultural, religious, legal and economic reasons and should be discussed with a fertility specialist to decide upon an individualised plan of action. In countries / cultures where egg donation is permitted this is the most successful way of achieving a pregnancy in this condition. Newer options such as stem cell technologies require further research before they can be routinely recommended.
The information in this article has been kindly supplied by the International Menopause Society, with contributions from the leading UK charity supporting women with POI, the Daisy Network.
At Hormone Health our team of hormone specialists are here to help. If you would like to discuss POI or any other health concern that you have, please get in touch to arrange a consultation.