Primary Ovarian Insufficiency
(Premature Ovarian Failure, Premature Menopause)
How to Say It: Pri-mary O-vair-e-un In-suff-e-shen-see
by Cynthia M. Johnson, MA
Primary ovarian insufficiency (POI) is the loss of ovarian function before 40 years of age. The ovaries are two small, oval-shaped organs in the pelvis. They release eggs and certain hormones called estrogen and progesterone.
In most women, the cause is not known. In others, it may be caused by problems that harm the ovaries, such as:
The risk of this problem increases with age. The risk is also higher in women who have been treated for cancer.
Missed or irregular periods are often the first symptom. Other problems may be:
The doctor will ask about your symptoms and health history. A physical and a pelvic exam will be done.
A blood test will be done to check hormone levels.
Any underlying causes will need to be treated.
The goal of treatment is to manage any problems caused by the change in hormones. Options are:
Infertility is a common problem with POF. In vitro fertilization (IVF) may be an option for women who want to become pregnant.
Women with cancer should discuss treatment options with their doctors.
American Congress of Obstetricians and Gynaecologists
RESOLVE—The National Infertility Association
The Society of Obstetricians and Gynecologists of Canada
Committee opinion no. 605: primary ovarian insufficiency in adolescents and young women. Obstet Gynecol. 2014;124(1):193-197. Reaffirmed 2020. Available at: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Primary-Ovarian-Insufficiency-in-Adolescents-and-Young-Women. Accessed February 24, 2021.
Premature ovarian failure: early menopause. American Pregnancy Association website. Available at:
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Accessed February 24, 2021.
Primary ovarian insufficiency (POI). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-ovarian-insufficiency-poi. Accessed February 24, 2021.
Primary ovarian insufficiency (POI). National Institute of Child Health and Human Development website. Available at: https://www.nichd.nih.gov/health/topics/poi. Accessed February 24, 2021.
Torrealday S, Kodaman P, et al. Premature Ovarian Insufficiency - an update on recent advances in understanding and management. F1000Res. 2017;6:2069.
Last reviewed December 2020 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG
Last Updated: 2/24/2021