The Dr James Brown website is not compatible with Internet Explorer. Please use a modern browser such as Chrome, Firefox, Edge, or Safari for the best experience.
Premature Ovarian Insufficiency (POI)
Premature ovarian insufficiency (POI) means the ovaries stop working normally before the age of 40. It can be a shock, and it raises important questions about fertility and long-term health. James has extensive specialist experience in diagnosing POI and providing both hormonal treatment and fertility guidance.
How can Dr James Brown help?
James provides a clear diagnosis, explains the likely cause, and develops a treatment plan covering symptoms, bone and heart health, and fertility. Where needed, he works alongside genetic counsellors, psychologists, bone health specialists and fertility clinics to provide coordinated care.
POI occurs when the ovaries produce less oestrogen and release eggs less regularly than they should before age 40. It affects about 1 in 100 women. It was previously called premature ovarian failure, but the ovaries can still work intermittently, so “insufficiency” is more accurate.
Symptoms include irregular or absent periods, hot flushes, night sweats, vaginal dryness, low mood, poor sleep, and reduced libido. Some women have no symptoms other than their periods stopping.
In most women, no cause is found. Known causes include:
- Genetic conditions, such as Turner syndrome or a fragile X (FMR1) premutation.
- Autoimmune conditions, where the immune system affects the ovaries.
- Cancer treatment, including chemotherapy and pelvic radiotherapy.
- Surgery, such as removal of both ovaries or some ovarian surgery.
- Family history of early menopause.
Diagnosis is based on your age, at least four months of irregular or absent periods, and raised follicle-stimulating hormone (FSH) levels on blood tests repeated at least four weeks apart. Further tests may include a chromosome analysis, an FMR1 test, thyroid and adrenal antibody tests, and a bone density scan.
Oestrogen protects the bones, heart and brain. Women with POI are without it for many more years than women who go through menopause at the usual age, which raises the long-term risk of osteoporosis, heart disease and other health problems.
For this reason, hormone replacement is recommended for most women with POI until around the average age of natural menopause (about 51). This is treatment to replace what your body would normally make, and the safety concerns that apply to older women starting hormones do not apply in the same way.
Natural pregnancy is uncommon but possible, occurring in around 5–10% of women with POI, and it cannot be predicted. If you are not planning pregnancy, contraception may still be advisable. For women who wish to conceive, options include IVF using donor eggs. Women facing cancer treatment may be able to preserve fertility before treatment starts, by freezing eggs or embryos.
James can discuss the options with you, and coordinate with fertility specialists when needed.
Have more questions?
Bookings: 1300 722 206