Premature Ovarian Insufficiency (POI)
Find out more about Premature Ovarian Insufficiency, its symptoms and treatment
What is Premature Ovarian Insufficiency (POI)?
The menopause usually occurs around the age of 51, premature menopause or Premature Ovarian Insufficiency (POI) is defined as the loss of ovarian function occurring before the age of 40.
The diagnosis of premature ovarian sufficiency is based on symptoms and confirmed with a blood test. The ovarian function can fluctuate so it is very important that before confirming this diagnosis two sets of blood tests are taken at least four to six weeks apart.
What are the symptoms?
The symptoms of Premature Ovarian Insufficiency include the usual symptoms that occur around the menopause, these include hot flushes, night sweats, headaches, poor sleep, loss of libido and vaginal dryness. Other symptoms include dry skin, aching bones and joints, brain fog and mood swings. The psychological symptoms of the menopause such as depression and anxiety are especially common in women with POI.
Long term effects of POI
The loss of ovarian function or the loss ovarian oestrogen puts women at an increased risk of osteoporosis, heart disease and possibly dementia. In fact, the overall mortality is increased in women with premature ovarian insufficiency.
The most distressing consequence is loss of fertility, which results from the ovaries’ inability to release eggs. However ovarian function can fluctuate particularly in the first few years following the diagnosis, and there is a small chance, around 5% that a woman may conceive naturally during this time. However, there is no reliable medical treatment to increase fertility in women with POI.
How can it be treated?
The most appropriate treatment is HRT. It is safe and effective in alleviate the climacteric symptoms and prevents the long-term problems of osteoporosis and heart disease. Some studies suggest that HRT can also reduce the risk of dementia. Women should aim to take HRT at least until the age of 50 which is the usual age of the menopause.
Book your appointment
Book your appointment with our specialist team
Dr Neale Watson
Consultant Gynaecologist
Dr Mike Savvas
Consultant Gynaecologist
Dr Marilena Nicou
GP Menopause specialist
Frequently Asked Questions
WHEN CAN I EXPECT TO EXPERIENCE THE MENOPAUSE?
The average age of the menopause is around 50 but in 5% of women it occurs before the age of 45 and this is termed an early menopause. In one percent of cases, menopause occurs before the age of 40 and that is termed premature menopause or premature ovarian insufficiency.
DO I NEED A BLOOD TEST TO DIAGNOSE MENOPAUSE?
Blood tests are not usually necessary to diagnose the menopause but may be useful if in very young and young women (before the age of 40). Blood tests can also help to exclude other conditions such as anaemia or underactive thyroid which can mimic some of the symptoms of the menopause.
What can be done for symptoms of vaginal dryness and pain during sex?
HRT in the form of oral tablets, patches or gels may help with vaginal dryness but sometimes vaginal dryness persists despite hormone replacement therapy. It may be associated with urinary symptoms such as frequency and urgency. Vaginal oestrogen in the form of a vaginal tablet of cream can help with these symptoms, the dose of oestrogen is very low, and it acts locally with negligible absorption into the bloodstream. It may therefore be used in women who are unable or do not want to take systemic HRT.
What to Expect From Your Visit
The first visit will entail a comprehensive consultation, examination and hormone profile testing if required. Our highly qualified menopause specialists will guide you through the process of choosing the safest and most effective treatment to manage your symptoms.
A prescription will usually be issued, at the first visit if appropriate and a follow-up is arranged after 2-3 months to assess the effectiveness of the treatment and make changes as required. Our clinic allows for remote consultation for those who cannot make an in-person follow-up. This may be via a video or telephone call.
Additional services such as pelvic ultrasound scan, coil fittings, smear tests and bone density scan (DEXA) may also be performed as appropriate. We can also arrange for you to have a mammogram if you need one.