Premature ovarian insufficiency: When ovaries retire early.
10.47102/annals-acadmedsg.2024227
- Author:
Stella Rizalina Sasha SUGIANTO
1
;
Lisa WEBBER
2
;
Farah SAFDAR HUSAIN
3
;
Veronique VIARDOT-FOUCAULT
4
;
Sadhana NADARAJAH
4
;
Jiin Ying LIM
5
;
Ee Shien TAN
5
;
Tze Tein YONG
2
;
Rukshini PUVANENDRAN
3
Author Information
1. Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
2. Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.
3. Department of Family Medicine, KK Women's and Children's Hospital, Singapore.
4. Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore.
5. Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.
- Publication Type:Review
- Keywords:
amenorrhoea;
cardio-metabolic disease;
hormone replacement therapy;
hormone therapy;
obstetrics and gynaecology;
osteoporosis;
premature menopause;
premature ovarian failure
- MeSH:
Humans;
Primary Ovarian Insufficiency/drug therapy*;
Female;
Estrogen Replacement Therapy;
Singapore;
Adult
- From:Annals of the Academy of Medicine, Singapore
2025;54(3):178-191
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Premature ovarian insufficiency (POI) refers to loss of ovarian activity before the age 40 years. POI has significant detrimental effects on health (infertility, cardiovascular diseases, type 2 diabetes, reduced bone density, dementia), well-being and longevity. This summary is a practical toolkit for health-care professionals (HCPs) looking after women with POI.
METHOD:A workgroup comprising specialists in gynaecology, reproductive medicine, endocrinology, genetics and family medicine reviewed relevant guidelines and literature on POI to establish recom-mendations for the diagnosis and management of POI in Singapore.
RESULTS:A summary to assist HCPs manage POI was produced, outlining: (1) the aetiology and conse-quences of POI; (2) making the diagnosis; (3) hormone therapy (HT) prescribing options including for those with additional medical conditions; (4) counselling women with POI about HT; and (5) long-term management of POI.
CONCLUSION:Timely diagnosis and management of POI is vital to prevent long-term adverse consequences, except infertility. HT is the mainstay of treatment and there are no alternatives as effective. Contraindications are very few; estrogen-sensitive cancer is the main contraindication, and caution in prescribing may be needed with established coexisting cardiovascular disease. Estrogen dosage is higher than when treating normal menopause, and as a result, the patient might require more progestogen for endometrial protection. Minimising cardiovascular risk factors by following a healthy lifestyle is important. POI is a significant public health issue and it is imperative that women have affordable access to appropriate HT. Large-scale research on POI in Asian women is needed.
