[Premature ovarian insufficiency - patients are underdiagnosed and undertreated]

Women presenting with amenorrhea and elevated serum levels of FSH before the age of 40 may suffer from premature ovarian insufficiency (POI). POI can be caused by ovarian damage through surgery, irradiation and chemotherapy. Autoimmune disease and genetic causes are also possible causes for development of POI. Since today we have a wide diagnostic arsenal available for patients, all women should be offered extended investigation. It is also important that affected women receive sufficient estrogen supplementation to avoid complications of POI, such as cardiovascular disease, osteoporosis and cognitive impairment. Supplementation should be given at least until the normal age of menopause, about 51 years of age. Although the condition is often complicated by infertility, it is important to inform patients that some residual fertility potential may exist in the case of secondary amenorrhea and POI.