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Early Menopause and Premature Ovarian Insufficiency (POI)

By Mehmet Şişoğlu (developer of Pausa), based on the sources below · Updated 27 October 2026

Menopause usually happens between 45 and 55. When it happens before 45 it is called early menopause; before 40 it is called premature ovarian insufficiency (POI), sometimes premature menopause.

POI is more common than once thought. An international guideline led by ESHRE, the European Society of Human Reproduction and Embryology, estimated in 2024 that about 3.5% of women are affected. It can happen naturally, after surgery that removes both ovaries, or after treatments such as chemotherapy or radiation therapy.

Because the body has less estrogen for more years, POI matters beyond symptoms: the guideline highlights effects on bone, heart and brain health. Hormone therapy can reduce some of these effects, which is why it is usually discussed early. Your specialist will explain what is recommended for you.

Quick answers

How is POI diagnosed?

In someone under 40, from absent or irregular periods together with a raised FSH blood level (above 25 IU/L). Since the 2024 update of the ESHRE guideline, one raised result is enough, with further tests if the picture is unclear.

What about early menopause between 40 and 45?

The NICE guideline suggests an FSH test may be considered between 40 and 45 when symptoms and cycle changes point to menopause. Because estrogen falls earlier than usual, it is worth talking about bone and heart health with your clinician.

Can I still get pregnant?

Sometimes. In POI, the ovaries can work on and off, so pregnancy is possible though less likely. If you don’t want to become pregnant, ask about contraception; if you do, ask about fertility options early.

When to talk to a clinician

• Your periods stop or become irregular before 45, especially before 40.
• You have had surgery or treatment that affected your ovaries.
• You have menopause symptoms in your 30s.
• You are thinking about pregnancy, now or in the future.

How logging helps

Dates of periods and symptoms over a few months help a clinician see what is happening. Pausa tracks symptoms whether or not you still have periods, and your notes stay on your iPhone and in its own backup, never on a Pausa server.

For personal awareness only. Not a substitute for medical advice.