Primary Ovarian insufficiency effects 1% of women and occurs when a woman’s periods stop below the age of 40 so it is not as rare as many people believe. The process by which this happens is entirely different to an ordinary menopause (where the egg supply naturally runs out) in that it is an autoimmune condition whereby the body creates antibodies directed towards the eggs or their hormonal receptors. It is associated with other autoimmune conditions, including coeliac, thyroid and adrenal gland diseases as well as some genetic diseases. It tends to run in families. POI can also be brought on by cancer treatments such as chemotherapy. It is diagnosed through symptoms such as irregular or absent periods, hot flushes and sweats and vaginal dryness, in combination with serial blood tests.
The ovaries can sometimes spontaneously recover such that there is a 5-10% chance of spontaneous conception in those women diagnosed with POI. It is important that women with POI have their menopause managed appropriately, ideally with HRT, as they are at increased risk of cardiovascular disease and osteoporosis in the future. For those women hoping to conceive HRT is not contraception.