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Treating Primary Ovarian Insufficiency (POI) with Hormone Replacement

Doctors use the medical term Primary Ovarian Insufficiency – or POI – to refer to a condition where a woman’s ovaries stop working normally before she is 40 years of age. In years past, POI was often referred to as “premature menopause” or “premature ovarian failure”.  But modern medicine now recognizes that those terms are not a truly accurate way to describe Primary Ovarian Insufficiency.

The difference between “early menopause” and POI is that a woman who has gone through menopause will never have another menstrual period and cannot get pregnant. However, a woman suffering from Primary Ovarian Insufficiency may still have periods, even though they may be irregular, and she may still be able to get pregnant. So POI is not really an “early” menopause at all!

What are the symptoms of primary ovarian insufficiency?

The first sign of Primary Ovarian Insufficiency is typically missed or irregular periods – medically known as “amenorrhea”. Additionally, many women afflicted by Primary Ovarian Insufficiency will experience symptoms that are very similar to natural menopause, including:

  • Hot flashes
  • Night sweats
  • Irritability
  • Poor concentration
  • Decreased libido
  • Painful sex
  • Vaginal dryness & itching

However, many women with POI do not experience these symptoms – and the first time they realize something is wrong is when they are unable to get pregnant, so they see a doctor for “infertility.” This is sometimes called “occult” (hidden) or early Primary Ovarian Insufficiency.

What are the risk factors for primary ovarian insufficiency?

There are a wide variety of factors that can put a woman at risk for Primary Ovarian Insufficiency. Heredity is one of the main culprits.  Women whose mother, sister or aunt has Primary Ovarian Insufficiency are more likely to also suffer from POI. In fact, it is estimated that approximately 10% to 20% of women with Primary Ovarian Insufficiency have a family history of POI.

Certain genetic conditions also put women at much higher risk for Primary Ovarian Insufficiency. It is estimated by experts that chromosomal abnormalities – such as “Fragile X Syndrome” or “Turner Syndrome”  – are responsible for approximately 28% of POI cases.

Other factors that are believed to cause or contribute to the development of Primary Ovarian Insufficiency include: certain autoimmune disorders, some viral infections, chemotherapy, and other medical treatments.

The autoimmune disorder thyroiditis – an inflammation of the thyroid gland – is very commonly associated with Primary Ovarian Insufficiency. Addison’s disease is another condition associated with Primary Ovarian Insufficiency – accounting for approximately 3% of POI cases.

Toxins such as cigarette smoke, chemical exposure (e.g. in cleaning professions), and pesticides can also speed up follicle depletion, contributing to the development of Primary Ovarian Insufficiency.

How is primary ovarian insufficiency diagnosed?

The key symptoms of Primary Ovarian Insufficiency are:

  • Missed or irregular periods for 4 or more months
  • Blood tests revealing high levels of follicle-stimulating hormone (FSH)
  • Blood tests revealing low levels of the hormone estrogen

Treating Primary Ovarian Insufficiency with Hormone Replacement

Hormone Replacement Therapy (HRT) is the most common treatment for women with Primary Ovarian Insufficiency. HRT provides the body with the missing estrogen and other depleted hormones that the ovaries are not making.

Typically, when a woman with Primary Ovarian Insufficiency begins Hormone Replacement Therapy, she can be expected to start having her regular periods again. And, as an added benefit, hormone therapy is generally also expected to reduce other “menopause-like” symptoms, including hot flashes, “brain fog” and night sweats – as well as help maintain bone density.

Recent research also seems to indicate that Hormone Replacement Therapy may even be associated with improved pregnancy success rates for some women with Primary Ovarian Insufficiency – by lowering high levels of luteinizing hormone.

Hormone Replacement Therapy for Primary Ovarian Insufficiency is usually a combination of an estrogen and a progestin. It is considered essential to take a progestin along with estradiol to balance out the effects of estrogen on the lining of the womb. Taking progestin along with estradiol reduces the risk of a woman developing endometrial cancer.

Typically, a woman with Primary Ovarian Insufficiency will undergo Hormone Replacement Therapy until she is about 50 years old, the age at around which menopause usually begins.

Hormone Replacement Therapy for Primary Ovarian Insufficiency

If you have been diagnosed with Primary Ovarian Insufficiency – or have experienced symptoms of so-called “early menopause” – it is essential to discuss Hormone Replacement Therapy with your physician.

Or, if you live in the greater Phoenix area, you may schedule a consultation with the hormone experts at SottoPelle in the Phoenix, AZ area today. If you live outside of the greater Phoenix area, you can also find a physician in your area who is highly trained in hormone replacement using our Physician Finder HERE.

The SottoPelle Bioidentical Hormone Replacement method offers the most natural, effective, and convenient form of HRT – utilizing time-released subdermal pellets that last up to 4 months in women with a single insertion!

Women’s Hormone Therapy | Phoenix:  (323) 986-5100

IMPORTANT DISCLAIMER: This article is provided as general information only and is not intended to be used as medical advice. While the benefits of hormone replacement are well documented through clinical research, we are not representing that hormone therapy is a “cure” for any disease. Only your treating physician can determine if hormone replacement may be a beneficial part of your healthcare regimen, based on your age, overall health, risk factors, and lifestyle.