Premature Ovarian Insufficiency (POI)
Premature Ovarian Insufficiency, or POI (previously Premature Ovarian Failure, or POF) affects approximately 1 out of every 1000 women between 15-29 years of age. If you have been diagnosed with POI, you feel alone and different. It might help you to know that there are thousands of other young women who have POI, too.

It can also help you feel better to know that doctors and scientists are also doing research to learn more about POI. This guide was created to answer your questions as well as offer information about fertility options.

What is premature ovarian insufficiency (POI)?
Most girls who have POI report that they went to their doctor when they stopped having periods. Girls with POI may have one or more of the following symptoms:

• lack of breast development during puberty
• lack of menstrual periods
• decrease in breast size
• hot flashes
• vaginal dryness
• mood swings
• insomnia (not being able to sleep)

The two most common symptoms are lack of breast development and lack of menstrual periods.

How is POI diagnosed?
Your doctor can find out if your ovaries are working by doing a simple blood test to check the hormone level, FSH (Follicle Stimulating Hormone). It's usually necessary to repeat the blood test to make sure the first test was correct. High levels of FSH in a blood test usually mean that you have POI.

Your health care provider will also check other hormones and genetic tests to see if there is a reason for the POI. Make sure to tell your health care provider about others in your family with POI or other health conditions (autoimmune conditions, endocrine problems, retardation, neurological diseases).

How is POI treated?
The treatment for POF is to replace the hormones that your body is no longer making. The name for this type of treatment is called hormone replacement therapy, or HRT. The hormones that need to be replaced are estrogen and progesterone. These hormones are necessary for breast development, menstrual periods, and healthy bones.

There are many different types of HRT. HRT is available as skin patches, pills, vaginal rings, and shots. Skin patches or “transdermal estrogen” provides estrogen levels most like what your ovaries would make. The estrogen patches are applied to the skin once or twice a week. The progesterone is usually a separate pill. Estrogen also comes in pills just for HRT. In addition, birth control pills and the birth control patch and ring can be used for HRT because they contain both estrogen and progesterone although the dose may be higher than needed just for replacement. Rarely women have become pregnant on HRT. You should discuss all the options with your health care provider