Aka Premature Ovarian Insufficiency (POI). If you're under 40 and getting menopausal symptoms this is the one for you. Heard about POI and wondered what it is? Here we explain what an early menopause is and what to do if this is relevant to you.
POI is when periods stop for one year before the age of 40. Sometimes this is a true 'early menopause' - when the ovaries stop working - but not always.
It's important to realise that if your periods have stopped for a year and you are under 40 it may not be the end of your reproductive life. If you are taking any form of hormonal contraception this can impact your periods. So can other things going on in your life - such as stress. It is important to seek help from a medical professional to understand what is going on.
POI is not uncommon - it's estimated to affect 1% of women under 40. It can happen at any age after puberty. 
No they are slightly different. An early menopause is when periods stop for one year between the ages of 40 and 45. POI is before 40.
Not all causes of POI are yet know. The most common known causes are genetic.
In some cases autoimmune diseases can lead to POI. Our immune system affects our sex hormones - including oestrogen, progesterone and testosterone. If something goes wrong with our immune system our sex hormones can get out of whack! Autoimmune thyroid problems are one of the more common causes of POI.
Chemotherapy and radiotherapy treatments for cancer can also cause periods to stop. This likelihood of this happening will depend on the drug, dose and duration of treatment.
Other causes can be surgical removal of the ovaries, or a hysterectomy. Some enzyme deficiencies and infections have also been shown to cause POI.
Go to your GP for further investigation. They may refer you to a specialist, depending on the other symptoms you are presenting with. Often they will run a blood test to check the hormone levels of FSH. FSH will be high if you are perimenopausal. This test needs to be repeated, so you have two consistent high readings over a 6-8 week period. They'll also check in on your thyroid function too.
There's some important long term health risks with going through menopause early - so it's important to know what's going on. There are increased risks of:
The good news is that the chances of getting breast cancer are a bit lower! Most of these risks were identified from women who had a surgically induced premature menopause. More research is needed into the risks associated with a natural early menopause.
If you do have POI the medical guidelines state that you should be offered counselling as a form of support. Also hormone replacement therapy should be offered to reduce some of the health risks. Your doctor may also suggest lifestyle changes to help you stay healthy. These may include eating calcium and taking a vitamin D supplement; maintaining a healthy weight; and keeping active.
It can be a scary diagnosis - but the health system should be there to help you. Treatment and support may need to last some years - and that is OK. Make sure you get the help you need.
1 Hillard T., et al. (2017). Management of the menopause. 6th edn. British Menopause Society. UK.
2 National Health Services Website (2017). *Early menopause * Retrieved 9 October 2019 from [https://www.nhs.uk/conditions/early-menopause/].