Premature ovarian insufficiency (POI)


Hello everyone,

“LIFE HAS A FUNNY WAY OF WORKING OUT JUST WHEN YOU START TO BELIEVE IT NEVER WILL”. This is me again with one of the untouched topics.

“Premature ovarian insufficiency(POI)”.

When I learned this, in my MBBS it was NOT one of the important topics we prepare for exams. In the postgraduation, learned a bit more about it but still was not weighed that much. Its been almost 20 yrs since my admission to MBBS, the scenario has changed a lot. As an infertility specialist, I see POI more frequently now, than before. In my 10 yrs practice, I have learned and evidence also shows that our fertility is in decline, for both men and women. Sperm count or egg count has declined significantly in the last few years. This situation may worsen in the future.

So it is important for us to be aware of POI and what are its implications. I will be sharing series of blogs and videos on this topic every week. I personally feel very much connected with these women as there are a lot of issues that are not taken care of. It may be sexual health, psychological, emotional, functional, and long-term health conditions. I will be discussing each and every detail about premature ovarian insufficiency.

Kindly subscribe to my website to get more updates. The females suffering from POI can fill the form on the website and get connected for more help. In the current scenario of pandemics, as we try to stay away from hospitals, this virtual world may connect us for betterment. In the subsequent blogs, I will be talking about new advanced technique in this field which may turnout LIFE CHANGING for some.

Let's see, a little history about POI. This condition was described as “PRIMARY OVARIAN INSUFFICIENCY” by Fuller Albright in 1942. Since then different terms were used. “PREMATURE OVARIAN FAILURE” was used quite commonly till the last decade. Since the last decade consistently it is called “PREMATURE OVARIAN INSUFFICIENCY” to avoid the negative connotation of the word failure. The prevalence of POI is 1% in the population. The age-specific incidence is approximately 1 in 250 by age 35 years and 1 in 100 by age 40 years.


As we know at the birth of a female number of eggs in her ovary is fixed. With increasing, age egg number goes down and natural menopause occurs at an average, 50 years of age.

But in some women menopause may knock on the door before and it is labeled as premature menopause. In scientific terms, POI is described as cessation of menses due to loss of ovarian function before the age of 40 years.POI is a spectrum disorder and its continuum of impaired ovarian function. It is displayed as occult, biochemical and overt. That means in the initial period body doesn’t respond to hormones as required but hormone levels, menstrual cycles are normal. In the next stage, hormones are deranged, fertility reduced but still, menstruation is cyclical.

The overt phase has irregular or absent menses, fertility drastically reduced, and abnormal hormone values. So sometimes when everything seems normal but still not able to become pregnant, it may be the initial stages of POI. Getting aware of your fertility potential helps in avoiding the difficult journey of Infertility.

One more thing we need to understand is the implications for relatives of women with POI. Women with at least one affected family member( mother, sister) may be at risk of POI, but currently, it is not possible to predict or prevent the onset.

There is evidence of heritability of age at menopause. If the mother had premature menopause there are likely chances that the daughter may inherit the same condition.

There are some hormonal tests to determine the onset of menopause but their predictability needs to be established.

It may be appropriate for these women not to postpone pregnancy, although the decision to start a family involves many factors. But their potential risk of early menopause should be taken into consideration when planning a family. Egg freezing may be an option for fertility preservation.

The consequences of POI are on each aspect of our body

Apart from Infertility, It causes reduced bone mineral density which makes women more prone to fractures, backache, osteoarthritis. Women with POI are at increased risk of cardiovascular diseases, reduced life expectancy, negative impact on psychological wellbeing, and quality of life. Sexual health and genitourinary functions are hampered. Hormone replacement therapy can be a promising treatment for women with POI.

So this was a brief introduction to premature ovarian insufficiency. In the next blog, I will discuss the symptoms and diagnosis of POI. I would like to highlight here the fact that, knowing your ovarian reserve in the reproductive age group can protect you from future complications. We need to have this new approach to look at our reproductive career.

So, see you in the next blog.


All the suggestions, comments are welcome.

Thank you,

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