Chapter 11 – Menopause

Premature ovarian insufficiency

Premature ovarian insufficiency (POI) (previously called premature menopause) is defined as the spontaneous onset of menopause before the age of 40 years. POI should be suspected in young women who present with menstrual irregularities, hot flushes, night sweats and vaginal dryness. It may be associated with a family history of early or premature menopause and is also associated with autoimmune conditions and chromosomal conditions such as Fragile X or Turner’s syndrome. It can follow cancer treatments, including chemotherapy and radiotherapy, to the pelvis.

Idiopathic POI occurs in about 1 per cent of women less than 40 years in most communities.(54)

Diagnosis is made when there has been more than four months of amenorrhoea, alternate  causes are excluded and finding of FSH raised to the menopausal range on two occasions four to six weeks apart. (70)



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