What is Premature Ovarian Insufficiency? (POI)

Approximately 1 in 10000 women under 20, 1 in 1000 women under 30, and 1 in 100 women under 40 are diagnosed with premature ovarian insufficiency (POI), formerly known as premature ovarian failure. That represents about 3.7% of all women worldwide. Women as young as 13 have been diagnosed as their periods never start in puberty.

Because of its striking similarities to menopause symptoms, medical professionals often treat it as such. Most of the time, the cause of POI is unknown; however, in certain cases, autoimmune disorders and genetic defects such as Addison's disease, Hashimoto's disease, and fragile X syndrome have been related to POI.

Blood tests are typically used for diagnosis, and they are repeated after six weeks. The blood tests look for decreased levels of eostrogen and increased levels of follicle-stimulating hormone (FSH). FSH levels above 40 mlU/ml are typically found in older postmenopausal women, but they are also seen in women with POI.

Treatment is the same HRT that is offered to older women experiencing menopause symptoms. Women with POI are encouraged to take HRT until they reach the more common age of menopause. Lower levels of oestrogen at a young age mean there is an increased risk of osteoporosis and heart disease. This also means some women can be on HRT for over 3 decades, but the benefits can far outweigh the risks of this medication.

It is a challenging diagnosis and can make some young women feel very lonely, as it isn't being discussed in mainstream media. It can be difficult to find a health professional who is knowledgeable about POI, making it challenging to access the healthcare and support that are needed.

Fertility can be a major aspect of a POI diagnosis; some women haven't started or completed their families yet and struggle with the possibility of not being able to conceive. Some women have young families and struggle with their day-to-day activities while suffering from menopausal symptoms.

Some women struggle with their self identity after a diagnosis, which can lead to feelings of inadequacy or a loss of femininity. It is important for women to seek support from loved ones, mental health professionals, or support groups to navigate these complex emotions and find ways to maintain a positive self-image. Remembering that a diagnosis does not define your worth or identity can be empowering in the journey towards self-acceptance.