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Health Information Center

Primary Ovarian Insufficiency

  • Cynthia M. Johnson, MA
Publication Type:


Primary Ovarian Insufficiency

(Premature Ovarian Failure, Premature Menopause)


Primary ovarian insufficiency (POI) is the loss of ovarian function before 40 years of age. The ovaries are two small, oval shaped organs in the pelvis. They release eggs and hormones called estrogen and progesterone.

Female Reproductive Organs.

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In most women, the cause of POI is not known. In others, it may be caused by problems that harm the ovaries, such as:

Risk Factors

The risk of POI increases with age. The risk is also higher in women who have been treated for cancer.


Missed or irregular periods are often the first symptom of POI. Other problems may be:

  • Hot flashes
  • Night sweats
  • Irritability
  • Problems with focus
  • Lack of interest in sex
  • Pain during sex
  • Vaginal dryness
  • Problems getting pregnant


The doctor will ask about symptoms and health history. A physical and a pelvic exam will be done.

A blood test will be done to check hormone levels.


Any underlying causes will need to be treated.

The goal of treatment is to manage any problems caused by the change in hormones. Options are:

  • Hormone replacement therapy (HRT) or estrogen/progestogen contraceptive pills to replace hormones until the age of natural menopause
  • Dietary changes or supplements that contain vitamin D and calcium to support bone health and lower the risk of osteoporosis
  • Lifestyle changes, such as exercising regularly, maintaining a healthy weight, and not smoking
  • Mental health therapy to cope with the emotions of having POI

Infertility is a common problem with POI. In vitro fertilization (IVF) may be an option for women who want to become pregnant.


Women with cancer should discuss treatment options with their doctors.





  • Committee opinion no. 605: primary ovarian insufficiency in adolescents and young women. Obstet Gynecol. 2014;124(1):193-197. Reaffirmed 2020.
  • Premature ovarian failure: early menopause. American Pregnancy Association website. Available at: https://americanpregnancy.org/womens-health/premature-ovarian-failure.
  • Primary ovarian insufficiency (POI). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-ovarian-insufficiency-poi.
  • Primary ovarian insufficiency (POI). National Institute of Child Health and Human Development website. Available at: https://www.nichd.nih.gov/health/topics/poi.
  • Torrealday S, Kodaman P, et al. Premature Ovarian Insufficiency - an update on recent advances in understanding and management. F1000Res. 2017;6:2069.


  • Beverly Siegal, MD, FACOG
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.