Menopause before 40 and spontaneous premature ovarian insufficiency

The ESHRE Guideline on premature ovarian insufficiency best practice recommendations for the care of women with with both primary and secondary premature ovarian insufficiency (POI). POI is a clinical condition defined by the loss of ovarian function indicated by irregular menstrual cycles together with biochemical confirmation of ovarian insufficiency before the age of 40.

Women with POI have unique needs. They may not only suffer from symptoms associated with estrogen deficiency, but can also experience other issues, with a significant impact on their quality of life and later health outcomes. POI can have significant effects on fertility, bone health, cardiovascular health, sexual function, psychological health and neurological function.

The impact of POI on these different domains and the treatment options for each along with monitoring needs where relevant are all discussed in the guideline.

In addition to hormone therapy the guideline also covers non-hormonal and complementary treatments, lifestyle interventions and puberty induction.

There are also patient resources as show below.

Patient resources

POI GUIDELINE Patient version2.28 MB

Fact sheets on topics related to POI co-created with women with lived experience - website

AMS Patient centered resources

Support groups

In addition to the support of family, friends and a healthcare team, some women find it useful to talk to other women in the same situation. Available support groups include:

ACCESS Australia (Australia’s National Infertility Network) – www.access.org.au

The Daisy Network Premature Menopause Support Group – www.daisynetwork.org.uk

NZ Early Menopause Support group – www.earlymenopause.org.nz

Where can you find information about other treatment options?

If your symptoms are bothering you, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms. Other fact sheets about treatment options include:

• Early menopause – chemotherapy and radiation therapy

• What is Menopausal Hormone Therapy (MHT) and is it safe?

• 9 myths and misunderstandings about MHT

• Non-hormonal treatment options for menopausal symptoms

• Complementary medicine options for menopausal symptoms

• Lifestyle and behaviour changes for menopausal symptoms

• Weight management and healthy ageing

• POI and Osteoporosis infographic 

The Healthtalk Australia Early Menopause online resource contains women’s stories, information, question prompt list and links to services: https://healthtalkaustralia.org/early-menopause-experiences-and-perspectives-of-women-and-health-professionals/overview-womens-experiences/

If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find an AMS Doctor service on the AMS website.

NOTE: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to an individual’s personal circumstances and should always be discussed with their own healthcare provider. This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members, other health professionals and their patients for clinical practice is permissible. Any other use of this information (hardcopy and electronic versions) must be agreed to and approved by the Australasian Menopause Society.

Content updated February 2025