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Premature ovarian insufficiency — SCE Endocrinology MCQ

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ModerateReproductive EndocrinologyPremature ovarian insufficiencySCE Endocrinology

A 34-year-old woman has amenorrhoea, hot flushes and vaginal dryness. Pregnancy test is negative. FSH is 68 IU/L on two samples 6 weeks apart, oestradiol is low and karyotype is 46,XX. She has no contraindication to oestrogen. What is the most appropriate management?

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Correct answer: D — Offer HRT or combined hormonal contraception until the usual age of menopause

Premature ovarian insufficiency is diagnosed by symptoms and repeated raised FSH before age 40; sex-steroid replacement protects bone and cardiovascular health. Reassurance alone would leave prolonged hypo-oestrogenism untreated. The pearl is that POI is managed differently from natural menopause in later life.

Reference: NICE NG23