POI is also known as Premature Menopause. It is due to depletion of ovarian reserve resulting in ovarian failure.

It occurs in:

1%         < 40 years
<0.1%    < 30 years

There are some identifiable causes including genetic and chromosomal causes, immunological, associated autoimmune conditions, smoking and infection. POI can also be due to medical interventions, eg hysterectomy, radiotherapy, etc.

Consequences

Short term

  • Menopausal symptoms which can affect quality of life
  • Fertility issues

Long term

  • Effect on bone with increased risk of osteoporosis and fractures
  • Earlier onset heart disease with long term increased cardiovascular mortality and total mortality. The risk increases with the earlier age at the time of diagnosis
  • Increased risk of early cognitive impairment; the risk increases with the earlier age of diagnosis
  • Diminished general and sexual wellbeing

Women need to be counselled for POI, discussing the short and long term consequences and the importance of lifestyle, bone health & individualised treatment options.