When is hormone replacement therapy recommended for premature ovarian insufficiency?

Premature ovarian insufficiency means ovarian function has reduced earlier than expected. Periods may become irregular or stop, and oestrogen levels may be low. Replacing oestrogen can help with hot flushes, sleep problems, vaginal symptoms, and bone protection. It may also support cardiovascular and overall health during the years when the body would usually still receive ovarian hormones.

Treatment is different from using hormones solely for typical menopause symptoms later in life. A clinician confirms the diagnosis, considers pregnancy plans, checks blood pressure and relevant medical history, and selects a route and dose suited to the person.

Arrange specialist follow-up to discuss hormone replacement therapy, bone health, fertility goals, contraception, and emotional wellbeing. Ask whether oestrogen should be combined with a progestogen if you have a womb. Hormone replacement therapy is not contraception, and ovarian activity can occasionally return, so pregnancy prevention may still matter.

Keep appointments for blood pressure, symptom review, and preventive care. Report side effects rather than changing the dose yourself. If treatment is unsuitable, non-hormonal symptom support and targeted bone-health measures can be considered.

Seek prompt assessment for new heavy or persistent bleeding, bleeding after sex, a new breast lump, or unexplained pelvic pain. Urgent help is needed for chest pain, sudden breathlessness, one-sided leg swelling, sudden weakness, or a severe allergic reaction.

Contact the care team if severe headaches, marked mood changes, or troublesome bleeding begins after a change in treatment. These symptoms may need an adjustment or further examination.

Ask: How long is hormone replacement therapy recommended in my situation? Do I need a progestogen? What contraception is suitable? How will you monitor bones and cardiovascular health? Could fertility return, and what support is available?