• The symptoms of premature menopause are those of typical menopause. They can include mood swings, vaginal dryness, cognitive changes, hot flashes, decrease in sex drive, and sleep disturbances. Diagnostic tests can show an elevated level of follicle-stimulating hormone (FSH) and low level of estradiol.

• Complications of premature menopause include infertility and an increased risk for osteoporosis.

• Hormone replacement therapy (HRT) is recommended for women diagnosed with early menopause in order to replace the hormones the body is missing.

It is recommended to:

• Ease menopausal symptoms

• Maintain bone density and reduce the risk of osteoporosis

• Reduce risk of early onset of cardiovascular and heart disease

• In one in 10 women, pregnancy can potentially occur spontaneously after the diagnosis of POF, and where a woman wants to have this chance of spontaneous pregnancy, the hormone therapy consists of continuous oestrogen with cyclic progestin therapy. Otherwise, a woman can be prescribed the oral contraceptive pill. Both of these therapies will normally give a monthly period. If your period doesn’t occur then a pregnancy test should be performed.

• Higher doses of hormones are often prescribed because younger women require more hormones to maintain quality of life and wellbeing..

• Long-term risks of hormone therapy

Although there are no long-term studies of HRT in women experiencing an early menopause, it is recommended that HRT should be taken to the expected age of menopause (45-50 years of age). All the studies of long-term use of HRT published in recent years have been in women some years after the expected age of menopause, who have much greater risks of heart disease, stroke and cancer because of their age

• Long-term follow up is recommended

• Monitor your symptoms and therapy

• Maintain regular monitoring of heart disease risks and bone density along withe surveillance to exclude the development of other gland failure mainly , thyroid, adrenals, and diabetes.

FAQ:

• What causes primary ovarian insufficiency?

• Although the exact cause of primary ovarian insufficiency may be unknown, a genetic factor or a problem with the body's immune system may play a role in some women. In an immune system disorder, the body may attack its own tissues-in this case, the ovaries.

• Primary ovarian insufficiency may develop after a hysterectomy or other pelvic surgery or from radiation or chemotherapy treatment for cancer. In some of these cases, the condition may be temporary, with the ovaries starting to work again some years later.

• How is primary ovarian insufficiency diagnosed?

• If your periods become irregular or stop, your doctor will do a physical exam and ask you questions about your general health and whether you have other symptoms of primary ovarian insufficiency. You will also have a pregnancy test. And your blood will be tested for other possible causes of irregular periods.

• To check for possible ovarian failure, your blood level of follicle-stimulating hormone (FSH) will be checked. FSH signals your body to release an egg every month. If the amount of FSH in your blood is higher than normal on more than one day, you may have primary ovarian insufficiency. Another blood test also may be done to measure the amount of estradiol (or estrogen) in your blood. Very low estrogen with a high FSH is a sign of primary ovarian insufficiency.

• Some women find out they have primary ovarian insufficiency when they see a doctor because they are having trouble getting pregnant.

• How is it treated?

Treatment for primary ovarian insufficiency will help you manage your symptoms. But there is currently no treatment that will make the ovaries start to work properly again. We may prescribe hormone therapy or other medicines to help with hot flashes. Hormone therapy can also help prevent early bone loss in women who have this condition.