Premature ovarian insufficiency
Investigation and treatment of premature ovarian insufficiency: hormonal diagnosis, hormone replacement and support, including for fertility.
What premature ovarian insufficiency is
We talk about premature ovarian insufficiency when the ovaries reduce or stop functioning before the age of 40. Periods space out or disappear, and symptoms typical of low oestrogen appear: hot flushes, dryness, mood changes. It affects roughly one in a hundred women under 40.
It isn't simply «early menopause»: at that age, the lack of oestrogen has consequences for bone and the cardiovascular system that can be prevented, and in some cases ovarian function fluctuates. That's why diagnosing and treating it in time matters so much.
When to book an appointment
- You're under 40 and have gone several months without a period, with pregnancy ruled out.
- Cycles that are increasingly spaced out or unpredictable.
- Hot flushes, night sweats or vaginal dryness before the age of 40.
- You're trying for a baby and it isn't happening, with irregular periods.
- A family history of very early menopause.
How we investigate it
The diagnosis relies on your medical history and a hormone test that's repeated to confirm it: a single abnormal value isn't a diagnosis. It's completed with a gynaecological ultrasound and, depending on the case, investigation of associated causes.
How we treat it
Unless contraindicated, the standard treatment is hormone replacement —hormone replacement therapy— continued until the natural age of menopause: it isn't «taking extra hormones», it's replacing the ones you'd normally have at your age.
If you want to get pregnant, your case and reproductive options are assessed with the Rincón Fertilidadunit, within the same group. Emotional support is part of it too: receiving this diagnosis young isn't easy, and you don't have to manage it alone — we have Psychology at the centre itself.
Frequently asked questions
Is premature ovarian insufficiency the same as early menopause?
They are similar, but not identical: in ovarian insufficiency the function of the ovary can fluctuate and even, in a small percentage of cases, allow a spontaneous pregnancy. That is why this name and a follow-up of its own are preferred.
Will I be able to get pregnant with premature ovarian insufficiency?
It depends on each case. The chance of spontaneous pregnancy is low but not zero, and there are assisted reproduction options that are assessed individually with the fertility unit.
How do you know if it is early menopause?
When periods stop or become very irregular before the age of 40 and symptoms such as hot flushes or dryness appear. It is confirmed with hormone blood tests — high FSH and low oestradiol, repeated over time — and the cause is investigated. It is not the same as amenorrhoea from another cause, and it is important to tell them apart.
Which factors bring the menopause forward?
Family history, smoking, surgery on the ovary, chemotherapy or radiotherapy, some autoimmune diseases and certain genetic abnormalities. In many cases no specific cause is found, and even so the diagnosis matters because of its consequences for bone and cardiovascular risk.