POI and Hormone Care
POI and Hormone Care
Living with Premature Ovarian Insufficiency (POI) can feel like a chapter of life was rewritten without warning. It is far more than a medical diagnosis; it affects how you feel in your body, how you plan for the future, and how you make sense of your health from day to day.
At Menopause Care, our BMS-registered doctors provide specialist care for people navigating POI at any stage. We take time to understand what you’re going through and tailor your treatment to your individual needs, because every experience of POI is different.
BMS accredited doctors, available online
Personalised treatment plan
A support team to help coordinate your care
Spread the cost of your care with Klarna
BMS accredited doctors, available online
Personalised treatment plan
A support team to help coordinate your care
Spread the cost of your care with Klarna
POI is more than early menopause
Premature ovarian insufficiency, often called POI, is a condition where the ovaries stop functioning as they should before the age of 40. This leads to reduced production of key hormones, particularly oestrogen, and can affect periods, fertility, bone health, heart health, and overall wellbeing.
For many women, POI is unexpected and distressing. Symptoms may develop gradually or appear suddenly, and the condition is often misunderstood or diagnosed late. With the right specialist support, it is possible to manage symptoms effectively and protect long-term health.
Premature ovarian insufficiency is diagnosed when ovarian function declines before the age of 40.
Although ovarian activity is reduced, POI does not always mean that the ovaries have completely stopped working. Some women with POI continue to have occasional periods, and a small proportion may ovulate intermittently.
POI was previously known as premature ovarian failure or primary ovarian insufficiency. You may still see these terms used, but POI is now preferred because it better reflects the variable nature of the condition.
Menopause and premature ovarian insufficiency are often discussed together, but they are distinct.
Menopause is a natural stage of life that happens as part of ageing, usually between the ages of 45 and 55, when the ovaries gradually stop producing hormones and releasing eggs.
Premature ovarian insufficiency occurs earlier and for different reasons. In POI, the ovaries are not functioning normally due to problems with the ovarian follicles, the structures that mature and release eggs. Hormone levels may fluctuate, and ovarian function can be intermittent rather than permanently absent.
Understanding this difference is important, as POI requires a specific clinical approach.
POI affects approximately:
- 1 in 100 women under the age of 40
- 1 in 250 women under the age of 35
It can occur at any point from the teens to the late 30s, although it is uncommon before the age of 30.
Common symptoms include:
- Irregular or absent periods
- Hot flushes and night sweats
- Vaginal dryness, itching, or discomfort
- Changes in libido
- Low mood, anxiety, or irritability
- Fatigue and low energy
- Reduced concentration or brain fog
- Difficulty conceiving
Symptoms vary from person to person and may change over time.
POI is not only about managing symptoms in the short term.
Low oestrogen levels at a younger age increase the risk of conditions such as osteoporosis and cardiovascular disease. National and international clinical guidance recommends hormone replacement for women with POI, unless there is a medical reason not to, until the average age of natural menopause.
POI can affect fertility, and this can be emotionally challenging. Some women with POI may ovulate occasionally, but spontaneous pregnancy is unpredictable.
Specialist clinicians can support conversations around fertility implications, hormone treatment, and appropriate referral for fertility counselling or services where needed.
Menopause Care does not provide fertility treatment, but our clinicians can help you understand your options and coordinate your care with you.
Is specialist POI support right for me?
You may benefit from specialist POI support if these feel true for you:
Treatment options for POI
Hormone replacement therapy (HRT) is a key treatment for premature ovarian insufficiency (POI). It replaces the hormones the ovaries are no longer producing and is generally recommended until at least the natural age of menopause, unless contraindicated. Treatment usually includes:
- Oestrogen to replace the hormones the ovaries are no longer producing
- Progesterone if you have a womb, to protect the lining of the uterus
- Testosterone in selected cases, where symptoms such as low libido persist.
In POI, hormone replacement is considered protective as well as managing symptoms. It supports bone, heart, and brain health, as well as improving quality of life.
Your treatment is personalised and reviewed regularly.
Alongside hormone therapy, your care may include:
- Bone health assessment and monitoring
- Lifestyle and nutritional guidance
- Vaginal oestrogen for local symptoms
- Psychological support where helpful
How our care works
- 1
Specialist consultation (45 min)
A menopause specialist doctor takes time to explore your symptoms, hormonal stage, medical history, and any existing ADHD diagnosis or concerns.
- 2
Personalised plan
Your clinician will create a personalised plan based on your symptoms, history and priorities — including hormone treatment where appropriate, practical lifestyle, and wellbeing support.
- 3
Ongoing review and support
Medication management, blood tests if needed, and continuity of care for as long as you need
Book your POI and hormone care appointment
.jpg&w=3840&q=75&dpl=dpl_8Xp7j4QRJ3fbGhKEaGyGsNDv214B)
45-minute online consultation with a specialist menopause doctor
Specialist support for people navigating POI, early menopause, or unexplained cycle changes — with a focus on both symptoms and long-term health.
30-minute online follow-up with a specialist menopause doctor
Ongoing review to ensure your treatment plan is working, symptoms are improving, and your hormone care remains safe and effective long-term.
Our Approach
Every person’s experience is different. Our role is to help you understand how hormonal changes may be affecting your body and mind, and explore safe and evidence-based treatment options that work best for you and your lifestyle.
Regular follow-up and ongoing support
Everything you want to know
POI is diagnosed based on symptoms, menstrual history, and hormone blood tests. Blood tests usually show raised follicle-stimulating hormone (FSH) levels on more than one occasion, along with low oestrogen levels.
Additional tests may be recommended to assess overall health and to rule out other causes of symptoms.
For most women with POI, hormone replacement therapy is recommended unless there is a medical reason not to. In POI, hormone replacement is considered protective and is usually advised until the average age of natural menopause.
Treatment helps manage symptoms and supports long-term bone, heart, and brain health.
HRT for POI replaces hormones that the ovaries would normally be producing at this stage of life. This is different from starting HRT around the usual age of menopause, when hormone levels naturally decline. Treatment is guided by national and international clinical recommendations and is generally continued until at least the natural age of menopause, unless contraindicated.
Your treatment is tailored and reviewed regularly to ensure it remains safe and appropriate.
Fertility can be affected in POI, but ovarian activity may be intermittent. A small number of women with POI may ovulate occasionally, although spontaneous pregnancy is unpredictable.
Specialist clinicians can support discussions around fertility implications and refer you for fertility counselling or services where appropriate.
In most cases, no clear cause is identified. POI can sometimes be associated with genetic factors, autoimmune conditions, medical treatments such as chemotherapy, or surgery involving the ovaries.
A family history of POI may increase risk.
Yes. Living with POI can be emotionally challenging, particularly due to unexpected symptoms, uncertainty, or concerns about fertility and long-term health. Psychological support can be an important part of care, alongside medical treatment.
POI is considered a long-term condition, although ovarian function can fluctuate. Treatment and follow-up are reviewed over time to support both symptoms and long-term health needs.
No. You can book a private specialist consultation at Menopause Care without a GP referral. With your consent, clinic letters can be shared with your GP to support joined-up care.
You should consider seeking specialist advice if your periods stop or become irregular before age 40, if you have symptoms of low oestrogen at a younger age, or if POI has been mentioned but not fully explained.
Early assessment and specialist care can make a meaningful difference.
A new patient menopause specialist consultation is £295 for 45 minutes. Follow-up options are £225 for 30 minutes.
Yes. Our doctors at Menopause Care are British Menopause Society-accredited and appear on the BMS specialist register.
Yes. Online consultations provide access to experienced perimenopause clinicians across the UK, with the same clinical standards as in-person appointments.
Menopause Care has clinics across the UK, including locations in London (Mayfair, Barnes, and Wimbledon), as well as Manchester, Sheffield, and Glasgow.
Your clinician will take a full medical history, discuss your symptoms in detail, and assess your individual risk factors. You will receive a personalised treatment plan and clear next steps, including options for lifestyle support, non-hormonal treatment, and hormone therapy where appropriate.
That is completely fine. Many people want clarity first. The first appointment is designed to give you a clear clinical assessment and a personalised plan, even if you decide not to start treatment straight away.
Specialist input can be especially valuable if you have migraines, high blood pressure, a family history of breast cancer, or other health considerations. Your clinician will take a careful, personalised approach and discuss options that fit your situation.
This is common. Symptoms may persist if the dose, type, or balance of hormones is not quite right. A specialist review can help assess what is happening and adjust your plan safely.
Yes. Menopause Care provides medical treatment directly through our partner pharmacy service (GPhC Registration: 9012909), ensuring you receive your care safely, conveniently, and without delay. Our clinicians review your progress regularly and tailor your medication journey to your individual needs, so you can feel confident that your care is both personalised and seamless.