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Primary Ovarian Failure

(Primary Ovarian Insufficiency, Premature Menopause)

Pri-mary O-vair-e-un In-suff-e-shen-see


Primary ovarian failure (POF) is the stoppage of ovaries before menopause has started. Ovaries make certain hormones called estrogen and progesterone that affect many parts of the body. Loss or changes in these hormones can affect the health of the bones, heart, and blood vessels.

Female Reproductive Organs

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Causes    TOP

POF is caused by damage or destruction of the ovaries. Common reasons include:

In some women, the cause may not be known.

Risk Factors    TOP

Factors that increase your chances of POF include:

Symptoms    TOP

Symptoms are similar to those of menopause and may include:

  • Irregular menstrual cycle
  • Hot flashes
  • Night sweats
  • Decreased interest in sex
  • Irritability
  • Difficulty sleeping
  • Vaginal dryness

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam and a pelvic exam may also be done.

The blood may be tested to look for changes in hormone levels.

Treatment    TOP

The goal of treatment is to manage any problems caused by the change in hormones. You and your doctor can talk about the best treatment plan for you. Options include:

  • Hormone replacement therapy (HRT) or estrogen/progestogen contraceptive pills—To replace hormones until the age of natural menopause.
  • Vitamin D and calcium supplement—To support bone health and reduce the risk of osteoporosis.

Infertility is a common problem with POF. In vitro fertilization may be an option for some who wish to have a pregnancy.

Women who are planning a procedure or treatment with a risk of POF may consider fertility preservation and family planning options before undergoing treatment. One option is to preserve healthy eggs to be used during in vitro at a later date.

Prevention    TOP

To help reduce your chance of getting POF, women with cancer should discuss cancer treatment options with their doctors.


The American Congress of Obstetricians and Gynaecologists


The Society of Obstetricians and Gynecologists of Canada


Premature ovarian failure: premature menopause. American Pregnancy Association website. Available at:
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Published August 2015. Accessed August 1, 2016.
Premature ovarian failure—what do I need to know? Resolve website. Available at:
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Published Summer 2012. Accessed August 1, 2016.
Primary ovarian insufficiency (POI). EBSCO DynaMed Plus website. Available at: Updated February 18, 2016. Accessed December 21, 2016.
Premature ovarian insufficiency. Patient UK website. Available at:
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Updated January 19, 2016. Accessed August 1, 2016.
Primary ovarian insufficiency (POI): overview. National Institute of Child Health and Human Development website. Available at: Updated April 12, 2013. Accessed August 1, 2016.
Primary ovarian insufficiency in adolescents and young women. American Congress of Obstetricians and Gynecologists website. Available at:
...(Click grey area to select URL)
Published July 2014. Accessed August 1, 2016.
Last reviewed August 2016 by Michael Woods, MD
Last Last updated: 12/21/2016

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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