Premature Ovarian Insufficiency: Practical Management Approaches

  • Sophia TsiligiannisEmail author
  • Nick Panay
  • John C. Stevenson
Part of the ISGE Series book series (ISGE)


Premature ovarian insufficiency (POI) is defined as the cessation of ovarian function before the age of 40 years. The triad of amenorrhoea, elevated gonadotrophins and estrogen deficiency is associated with long-term health consequences including increased cardiovascular disease (CVD), decreased bone mineral density (BMD), significantly reduced fertility, psychological distress, vulvovaginal atrophy, neurological effects and overall reduced life expectancy.

There are deficiencies in our understanding of the condition and subsequently the long-term health consequences associated with it. The underlying aetiology of POI and the optimum management strategies are also poorly understood. Our knowledge of long-term cardiovascular consequences specifically relating to women with POI is limited as most data on the subject are derived from studies involving women who experienced menopause at the natural age (beyond 40 years with an average age of 51).

There are however randomized controlled trials of hormone therapy planned to provide evidence for treatment, and a prospective international registry has been set up to collate multicentre data with the aim of improving care for women with POI.


Premature ovarian insufficiency (POI) Amenorrhoea Cardiovascular disease POI registry 


Conflict of Interest

In the past 5 years, Dr. John C. Stevenson has received grants/research support from Abbott, Mylan and Pfizer, consulting fees from Abbott and Pfizer and speakers’ honoraria from Abbott, Bayer, Gedeon Richter, Menarini, Mylan and Pfizer.

In the past 5 years, Nick Panay has received grants/research support from Abbott, Mithra and Mylan and honoraria/expenses for speaking/advisory work from Abbott, Bayer, Besins, Novo Nordisk, Meda, MSD, Pfizer, SeCur and Shinogi.


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Copyright information

© International Society of Gynecological Endocrinology 2019

Authors and Affiliations

  • Sophia Tsiligiannis
    • 1
    Email author
  • Nick Panay
    • 1
    • 2
  • John C. Stevenson
    • 3
  1. 1.Chelsea and Westminster HospitalLondonUK
  2. 2.Imperial College Healthcare NHS TrustLondonUK
  3. 3.National Heart & Lung Institute, Imperial College LondonRoyal Brompton HospitalLondonUK

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