Recommendations Updated on Diagnosis, Management of Premature/Primary Ovarian Insufficiency

MONDAY, Dec. 16, 2024 (HealthDay News) — In an evidence-based guideline issued by the Centre for Research Excellence in Women”s Health in Reproductive Life and published online Dec. 8 in Climacteric, updated recommendations are presented for the diagnosis and management of premature/primary ovarian insufficiency (POI).

Nick Panay, M.D., from Queen Charlotte”s and Chelsea Hospital at Imperial College London, and colleagues developed guidelines relating to diagnosis and management of POI based on evidence collected from literature searches and assessment. In general, the recommendations were informed by women with lived experience of POI.

The authors note that the prevalence of POI is 3.5 percent, which is higher than previously thought. The updated guidelines included 145 recommendations. The list of clinical questions addressed in this guideline was expanded, including in relation to the role of anti-Müllerian hormone (AMH) in the diagnosis of POI and fertility preservation. The topic of complementary treatments was extended, focusing on nonhormone treatments and lifestyle management. Significant changes from the previous guideline include the recommendation that only follicle stimulating hormone (FSH) >25 IU is required for POI diagnosis and guidance that AMH testing, repeat FSH measurement, and/or AMH may be necessary in cases of diagnostic uncertainty. Recommendations relating to genetic testing, estrogen doses and regimens, use of the combined oral contraceptive, and testosterone therapy were also updated.

“The guideline group concluded that there is still an urgent need for more research on the most appropriate diagnostic and treatment options, but also to further elaborate the impact of estrogen deficiency on the health and life expectancy of the women diagnosed with POI,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text