Management of premature ovarian failure

Premature ovarian failure (POF), a major life-changing condition that affects a significant proportion of young women, remains an enigma and the researcher's minefield. As women increasingly survive childhood cancers due to improved iatrogenic interventions, the number of POF sufferers will inevitably increase. Numerous questions relating to this condition remain unanswered, and several important management issues are yet to be addressed. The challenges posed by this important condition range from difficulties with nomenclature to the absence of specific standardized diagnostic criteria and management guidelines. There is a particularly urgent need to determine the optimum therapeutic hormonal regimens in women with POF, both in terms of immediate symptom relief and also for protection against the long-term sequelae of an early menopause. This chapter discusses the management of POF, highlights the challenging issues, reviews the current literature and proposes a practical management outline based on the authors' own practice.