Primary Ovarian Insufficiency: The Paradox of Menopause in Young Women

Primary ovarian insufficiency (POI) refers to the loss of ovarian function in young women. It can lead to primary or secondary amenorrhea. The loss of ovarian function is usually permanent akin to menopause. Resultant hypoestrogenemia has systemic adverse effects particularly on the bone health. POI is diagnosed on the basis of raised serum follicle stimulating hormones levels. Most of the cases are idiopathic. Hypothyroidism is the most common associated disorder suggesting autoimmune etiology in some of the cases. Karyotypic abnormalities (mostly monosomy X-Turner syndrome) should be excluded in cases presenting with primary amenorrhea or early onset secondary amenorrhea. Treatment involves long-term estrogen-progesterone replacement therapy which provides regular withdrawal bleed and prevents systemic effects of hypoestrogenemia