Treatment of Menopause in Premature Ovarian Insufficiency or Early Menopause Before Age 45
When menopause occurs before age 45 — due to premature ovarian insufficiency or other causes — it represents a distinct clinical situation requiring a specific management approach, particularly in the absence of contraindications to hormone therapy.
This protocol applies to women with early menopause (onset before age 45) or premature ovarian insufficiency who have no contraindications to hormone therapy. Women without contraindications should receive hormone therapy until the average age of menopause (51 years).
Treatment approach
The first-line approach centres on hormone therapy, with the goal of continuing treatment until the typical age of natural menopause. Because of their younger age at onset, these women generally require higher doses than those used in older postmenopausal populations. The complete structured regimen — including agent selection and combination details — is available in the full protocol.
References
- Early menopause (< age 45) or premature ovarian insufficiency.
- Women without contraindications should receive HT until the average age of menopause (51 years).
- Typical daily doses for MHT in women with POI are 100 μg transdermal estradiol, 2 mg oral micronized estradiol, or 1.25 mg CEE, with 10mg MPA or 300 mg progesterone for 12 days per month.
- Younger women need higher doses of hormones.
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