Premature Ovarian Insufficiency (POI)

Premature ovarian insufficiency occurs when the ovaries stop functioning normally before the age of 40, leading to reduced oestrogen production and a decline in egg supply. It can affect fertility significantly and brings on symptoms similar to menopause, often unexpectedly and at a time when many women are still planning their families.

There are more options than you might expect

A POI diagnosis can be confronting and emotionally overwhelming, particularly for women who were not expecting it. The impact on fertility, combined with the sudden onset of menopausal symptoms at a young age, can feel like a great deal to process at once. Dr Rozen approaches these conversations with honesty and sensitivity, making sure every patient understands both the implications of their diagnosis and the options that remain available to them.

What causes POI?

In many cases the cause of POI is unknown. Where a cause is identified, it may include:

Genetic factors such as Turner syndrome or Fragile X syndrome
Autoimmune conditions where the body attacks ovarian tissue
Medical treatments including chemotherapy and radiation
Surgical removal of the ovaries

Common symptoms include

Irregular or absent periods
Hot flashes and night sweats
Vaginal dryness and discomfort during intercourse
Difficulty conceiving
Mood swings and emotional symptoms including depression

What treatment options are available?

Hormone replacement therapy (HRT)

HRT is typically recommended for women with POI to manage menopausal symptoms and reduce the longer-term risks associated with low oestrogen, particularly osteoporosis and cardiovascular health. For women with POI, HRT is generally considered important for overall health, not just symptom relief.

Calcium and vitamin D supplementation

To support bone health and reduce the risk of osteoporosis, calcium and vitamin D supplements are recommended alongside HRT.

Assisted reproductive technologies

For women with POI, natural conception can be possible with assisted reproduction. IVF with donor eggs also offers a genuine pathway to parenthood for those who cannot conceive with their own eggs. Dr Rozen will discuss all available options sensitively and honestly.

Psychological support and counselling

The emotional impact of a POI diagnosis can be profound. Psychological support and counselling are an important part of comprehensive care, and Dr Rozen factors this into the support she provides.

Regular monitoring

Given the longer-term health risks associated with POI, ongoing monitoring for bone density, cardiovascular health, and other associated risks is an important part of management.

Patient testimonial – Dr Genia Rozen fertility specialist

“A premature ovarian insufficiency diagnosis is one of the hardest conversations I have with patients. It’s unexpected, it’s significant, and it touches on so much more than fertility. My goal is to make sure every patient leaves that appointment feeling informed, supported, and knowing that there are still options worth exploring.”

– Dr Genia Rozen, Fertility Specialist, Genea Melbourne City and Frankston

Frequently Asked Questions

Can I still conceive with POI?

Natural conception is very difficult with POI, but it is not always impossible. For women who wish to have children, assisted reproductive options including IVF using donor eggs offer a genuine pathway to parenthood. Dr Rozen will discuss all available options based on each patient’s individual circumstances.

What is the difference between POI and menopause?

Menopause is a natural transition that occurs in women typically between the ages of 45 and 55. POI occurs before the age of 40, often unexpectedly, and is considered a medical condition rather than a natural life stage. The health implications of low oestrogen at a younger age are more significant and require active management.

Why is HRT important for women with POI?

For women with POI, HRT is generally recommended not only for symptom relief but for longer-term health protection. Low oestrogen at a young age increases the risk of osteoporosis and cardiovascular disease, and HRT helps mitigate these risks until the age at which natural menopause would typically occur.

What are the longer-term health risks of POI?

Because POI results in lower oestrogen levels at a younger age than natural menopause, the longer-term health implications can be significant and require ongoing monitoring. These include:

Increased risk of osteoporosis due to prolonged low oestrogen levels
Possible increased risk of heart disease
Emotional and psychological impact, including anxiety and depression