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Primary Ovarian Insufficiency Treatment Overview

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Care Plan

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First steps to consider

  • It’s important to see a healthcare provider to get a diagnosis of primary ovarian insufficiency (POI) and discuss a treatment plan. Symptoms include hot flashes, vaginal dryness, and infertility in women under age 40.
  • POI can be treated with hormone therapy.
  • Supplements and lifestyle changes can help prevent complications.
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When to see a healthcare provider

See a healthcare provider if you are younger than age 40 and have symptoms of primary ovarian insufficiency (POI), like hot flashes and vaginal dryness, or you haven’t had a period in 3 months or more. POI can cause serious complications like infertility and heart disease, so it’s important to get the right diagnosis and treatment.

You should also see a provider for POI because it can be caused by health problems that need to be identified and treated, like genetic conditions and autoimmune diseases.

Getting diagnosed

Your provider will ask for your medical history and do a physical exam. They may also request several tests to diagnose POI. These include:

  • Blood tests to check your hormone levels. Blood may also be taken for genetic testing, since certain genetic disorders can cause POI.
  • A pregnancy test to check for an unexpected pregnancy.
  • A pelvic ultrasound to check the condition of your ovaries.

What to expect from your visit

  • Hormone therapy is the most common treatment for POI. You’ll likely be prescribed a combination of estrogen and progestin. Hormone therapy lowers the risk of complications like heart disease and osteoporosis. It can also help other symptoms like hot flashes, vaginal dryness, and pain during sex. It is available in several forms, including pills, creams, patches, and a vaginal ring.
  • You may be referred to a therapist if you’re struggling with your mental health. Having POI can be difficult emotionally, especially if you had plans to start or grow your family.
  • If you have POI, want to have a baby, and are having trouble conceiving, your doctor may suggest trying in vitro fertilization. During in vitro, eggs are removed from a donor and fertilized with sperm. The fertilized egg is then placed in your uterus.

Prescription medications

  • Estradiol (oral) (Estrace)
  • Estradiol (patch) (Climara)
  • Estradiol (vaginal ring) (Femring)
  • Vaginal estrogen: Estrace (cream), Vagifem (tablet), Estring (vaginal ring).
  • Micronized progesterone (Endometrin, Prometrium)
  • Medroxyprogesterone (Provera, Depo-Provera)

Types of providers for primary ovarian insufficiency

  • A primary care provider can help rule out other conditions.
  • Ob/gyns, who specialize in women’s health, typically treat POI.
  • You may need a fertility specialist (reproductive endocrinologist) if you have POI, want to have a baby, and are having trouble conceiving.
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