New Guidelines on Diagnosis and Management of Premature Ovarian Insufficiency - Video

New guidelines on the diagnosis and management of premature ovarian insufficiency (POI)-developed by the Centre for Research Excellence in Women's Health in Reproductive Life (CRE-WHiRL) at Monash University, and key international women’s health organisations with an international team of experts including women with lived experience.

The guidelines were last updated in 2015 and the 2024 update of the premature ovarian insufficiency Guidelines of the European Society of Human Reproduction and Embryology (ESHRE).

The 2024 guidelines provide 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of premature ovarian insufficiency. The recommendations were developed using the best available evidence and graded according to the strength of that evidence. Topics to cover in the guideline were informed by an international survey of women and healthcare professionals. New information is provided about the genetic causes of premature ovarian insufficiency, the impact of premature ovarian insufficiency on muscle health, use of anti-mullerian hormone, non-hormonal therapies, lifestyle interventions and complementary therapies.

According to Co-Chair of the guideline development group, Associate Professor Amanda Vincent, from CRE-WHiRL, a key change of the updated 2024 guidelines is the recommendation regarding the diagnosis of premature ovarian insufficiency; only one elevated follicle stimulating hormone (FSH) level is needed combined with irregular or absent menstrual periods for at least four months. The FSH level only requires repeating if the diagnosis remains unclear. Women with lived experience provided recommendations on how to convey the diagnosis and care of women with premature ovarian insufficiency.

The updated guideline stresses the importance of personalised hormone therapy, unless contraindicated, for symptom relief and chronic disease prevention; with the need for prompt institution and continuation until the usual age of menopause.

Reference: Panay, N., Anderson, R. A., Bennie, A., Cedars, M., Davies, M., … Vincent, A. J. (2024). Evidence-based guideline: premature ovarian insufficiency†‡. Climacteric, 1–11. https://doi.org/10.1080/13697137.2024.2423213