Premature Ovarian Insufficiency (POI): A Current Overview of Diagnosis, Etiopathology, Epidemiology, Symptomatology, and Treatment Options

Abstract

Premature Ovarian Insufficiency (POI) is a pathological condition characterized by the cessation of ovarian function prior to an individual attaining the age of 40 years. This syndrome is marked by elevated levels of gonadotropins and diminished levels of oestrogen, ultimately leading to infertility. According to guidelines provided by the European Society for Human Reproduction and Embryology (ESHRE), diagnostic criteria for this condition include increased follicle-stimulating hormone (FSH) levels exceeding 25 IU/l tested on two separate occasions with a four-week interval between each measurement, together with the presence of amenorrhea or oligomenorrhea for at least 4 months. The occurrence of POI has been associated with adverse effects such as reduced fertility, irregular menstrual cycles, failed pregnancies, and a reduction in overall health-related quality of life. The early decline in oestrogen puts women at increased risk of osteoporosis, hypertension, cardiovascular disease, weight gain, type 2 diabetes, cognitive disorders such as Parkinson's, depression, and Alzheimer's disease, and dementia. In this respect, it has important consequences that negatively affect women. However, genetic abnormalities, metabolic problems, autoimmunity, iatrogenic causes, infections, or environmental variables have been identified that contribute to the development of premature ovarian failure syndrome in some patients. The etiopathogenesis of the disease remains largely unknown in the majority of cases. This review aims to review the available literature, focusing on the diagnosis, clinical aspects, causes, symptoms, complications, and treatment of POI.