investigations for ovarian failure

For diagnosing premature ovarian insufficiency (POI) in individuals under 40, consider their clinical and family history ⁴. The diagnosis is based on menopause-associated symptoms, such as absent or infrequent periods (accounting for hysterectomy), alongside elevated follicle-stimulating hormone (FSH) levels confirmed on two blood samples taken 4 to 6 weeks apart ⁴. A single blood test is insufficient for diagnosis ⁴. Anti-Müllerian hormone testing is not routinely used for diagnosing POI ⁴.

For women with irregular menstrual cycles, serum gonadotrophin measurements (follicle-stimulating hormone and luteinising hormone) are valuable for identifying ovulation disorders ¹,³. Serum progesterone measurement in the mid-luteal phase can confirm ovulation, even in women with regular cycles ¹. For those with prolonged irregular cycles, serum progesterone may need to be measured later in the cycle and repeated weekly until the next menstrual period begins ¹,³.

Thyroid function tests should only be offered to women with symptoms of thyroid disease ¹,³. Prolactin measurement is indicated for women with ovulatory disorders, galactorrhoea, or a suspected pituitary tumour ¹,³.