Primary ovarian insufficiency (POI) is the term used to describe when a woman’s ovaries stop working normally before she reaches the age of 40. POI is not the same as early or premature menopause. Many women with POI do not get monthly menstrual periods, or they have them irregularly. Problems with ovulation may make it difficult for women with POI to get pregnant. In addition, women with POI are at higher risk for certain health conditions, such as osteoporosis, than are women who do not have POI.
The NICHD studies a range of issues related to POI, including possible causes of and mechanisms involved with POI, conditions associated with POI, and treatments and support for the physical and emotional health of women and families affected by POI.
For more information about this topic, select the Condition Information, Research Information, Clinical Trials, or Resources and Publications link in the menu on the left.
Fast Facts
Common Name
- Primary ovarian insufficiency (POI)
Medical or Scientific Names
- Primary ovarian insufficiency
- Premature menopause
- Premature ovarian failure
- Ovarian hypofunction
- Hypergonadotropic hypogonadism
- Fragile X-Associated POI (FXPOI), used to describe POI related to a specific genetic change
Causes
There are many possible causes for POI, but in up to 90% of women, the exact cause is unknown. Genes, the immune system, infection, treatments for cancer, environmental and other factors all may play a role in reducing how well the ovaries work and may play a role in POI.
1 Number of Women Affected
Estimates of the number of women with POI in the United States are fewer than 200,000. Therefore the disorder qualifies as a rare disease.
2 Common Symptoms
- Irregular periods or no periods
- Hot flashes
- Night sweats
- Irritability
- Poor concentration
- Decreased sex drive
- Pain during sex
- Vaginal dryness
- Infertility
Women with POI are also at higher risk for certain other health conditions, such as osteoporosis (pronounced os-tee-oh-puh-ROH-sis), low thyroid function, and heart disease.
Common Treatments
Health care providers usually prescribe hormone replacement therapy to relieve some of the symptoms of POI and to prevent or reduce the risk of associated conditions, such as bone loss and heart disease. Currently there is no safe, effective treatment to restore normal function of the ovaries so as to improve fertility in women with POI. However, between 5% and 10% of women with POI are able to conceive without medical intervention.
- Nelson, L. M. (2009). Primary ovarian insufficiency. New England Journal of Medicine, 360, 606–614.[top]
- Coulam, C. B., & Stern, J. J. (1991). Immunology of ovarian failure. American Journal of Reproductive Immunology, 25, 169-174 [top]