Women with premature ovarian insufficiency (POI) have low levels of estrogen. After diagnosis, most women will therefore be recommended to take some form of estrogen replacement. This will help with the symptoms of POI (such as flushes, night sweats, mood disturbance, vaginal dryness) but estrogen is also important to protect the bones, heart and brain in the longer term. In women who still have their uterus (womb), estrogen also needs to be taken with a progestogen.
There are 2 main options for taking estrogen replacement:
• Hormone replacement therapy (HRT)
• Combined oral contraceptive pill (COCP)
Each of these options have different pros and cons. The most important thing is finding a medication that suits your lifestyle and doesn’t given you many side effects.
The COCP is easy to take, many women will have used it in the past and you may feel more comfortable being on the pill as it is something other girls or women your age may be taking. If you live in the UK you wouldn’t have to pay for your prescription because contraceptives are free.
HRT comes in many different preparations – pills, patches or gels and therefore it may offer more flexibility to find a preparation that suits you. HRT is thought to be more physiological (closer to how the body is meant to function) and in the long-term may have a more beneficial effect on blood pressure when compared with the COCP.
Hormone replacement is normally recommended until the average age of the natural menopause (around 52 years of age). In POI, there is no evidence that HRT increases risk of breast cancer over and above that found in women with a normally timed menopause (52 yrs). You can read about how to manage any side effects here.