Primary Ovarian Insufficiency

Primary ovarian insufficiency is a condition affecting the female reproductive system where the ovaries stop working properly before the age of 40. This leads to a decrease in the production of female hormones like estrogen, which are important for regulating the menstrual cycle and overall health. Women with this condition often experience irregular or absent periods, which can affect their ability to become pregnant. It can also cause symptoms related to low estrogen such as hot flashes, night sweats, and vaginal dryness. The condition impacts not only fertility but also bone health and cardiovascular risk due to hormone deficiency.

Primary ovarian insufficiency (POI) is defined as the loss of normal ovarian function before age 40, characterized by amenorrhea or oligomenorrhea lasting at least 4 months and elevated serum follicle-stimulating hormone (FSH) levels in the menopausal range on two occasions at least 1 month apart. The core pathology involves premature depletion or dysfunction of ovarian follicles, often due to genetic causes such as FMR1 premutation, autoimmune oophoritis, or iatrogenic damage from chemotherapy or radiation. POI results in hypoestrogenism and infertility, with significant implications for bone density, cardiovascular health, and psychosocial well-being. It is distinct from natural menopause by its earlier onset and potential for intermittent ovarian function.