Primary Ovarian Insufficiency

Primary ovarian insufficiency (POI) is a condition that occurs when a person’s ovaries fail earlier than average. Your ovaries are small glands located on both sides of your uterus that produce and release eggs during ovulation. Your ovaries also make important hormones for menstruation, pregnancy and other bodily functions.

The usual age for egg production to stop, known as menopause, is around 51. For some people, POI happens abruptly, and they suddenly stop having a regular menstrual period. But, for others, a diagnosis of POI comes after months or years of irregular periods.

Primary ovarian insufficiency was previously known as premature ovarian failure. However, healthcare providers prefer “insufficiency” rather than “failure” because research has shown that people with POI can have intermittent ovulation. This means you may still release an egg and get pregnant if you have POI. In fact, around 5% to 10% of those with a diagnosis of POI will spontaneously get pregnant without treatment for infertility. For this reason, POI is often also called “decreased ovarian reserve.”

How common is primary ovarian insufficiency?

POI is rare, typically affecting about 1% of women or people assigned female at birth (AFAB) between ages 15 to 44. It can affect both those who’ve had children and those who haven’t ever had children. It’s more common in people who are older than 30.

How does primary ovarian insufficiency affect my body?

Primary ovarian insufficiency causes low estrogen levels. Losing estrogen can have side effects similar to those that occur with menopause, such as hot flashes, decreased sex drive and mood changes. It also increases your risk for osteoporosis, heart disease and other conditions.

Many people with primary ovarian insufficiency experience infertility. However, your provider may be able to help you become pregnant with treatments like donor eggs, IVF (in vitro fertilization) and/or fertility medications.