What to expect from hormone replacement therapy for premature ovarian insufficiency

Premature ovarian insufficiency means the ovaries are working less consistently before the usual age of menopause. Treatment may use oestrogen, with a progestogen added when a person has a uterus to protect its lining. Delivery may be through tablets, patches, gel, or another prescribed option. The aim is hormone replacement rather than contraception, and ovulation can still happen unpredictably, so pregnancy planning needs a separate discussion.

Hot flushes, night sweats, vaginal dryness, sleep changes, and low mood may improve gradually. Your clinician may also discuss bone health, blood pressure, migraine history, and personal or family risks before choosing a regimen.

Take each medicine on the schedule provided and keep a simple record of bleeding, symptoms, headaches, skin reactions, and missed doses. Do not change the dose or stop suddenly without advice. Attend planned reviews so the regimen can be adjusted to your symptoms and stage of treatment. Ask about contraception if pregnancy is not wanted, and mention smoking, clotting problems, liver disease, migraines, or unexplained bleeding before treatment begins.

Contact your clinician about persistent or heavy bleeding, new severe headaches, troublesome mood changes, or symptoms that are not settling. Seek urgent help for chest pain, sudden breathlessness, coughing blood, one-sided leg swelling or pain, or sudden weakness or difficulty speaking. These symptoms need prompt assessment rather than a routine medication review.

Which hormone and delivery method fits my medical history? Do I need a progestogen? How will you review bone health and symptom response? Could this treatment affect contraception, fertility planning, migraines, or bleeding? What should I do if I miss a dose?