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Stages & types

Premature Ovarian Insufficiency (POI)

Premature ovarian insufficiency is when ovarian function declines earlier than expected, before the age of 40. It can cause symptoms similar to menopause, but it often needs a slightly different conversation because it is happening much earlier in life.

Stage 1

Perimenopause

The transition before menopause, when hormone levels fluctuate and symptoms may begin.

Stage 2

Menopause

The point reached once you have gone 12 months without a period.

Stage 3

Postmenopause

The years after menopause, when symptoms and longer-term health changes may continue.

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Premature Ovarian Insufficiency

When ovarian function declines before the age of 40.

Medical menopause

Induced Menopause

Menopause caused by surgery or medical treatment affecting the ovaries.

POI is menopause-like hormone change happening much earlier

When ovarian function declines before the age of 40, it is often called premature ovarian insufficiency or POI. It used to be described with older terms such as premature ovarian failure or premature menopause, but those terms are less helpful because ovarian function can sometimes fluctuate rather than stopping in a simple, complete way.

POI can be physically and emotionally difficult because it happens years, and sometimes decades, earlier than expected. It can affect symptoms, fertility plans, confidence and long-term health.

Periods may not fully stop straight away

Like perimenopause, POI can involve fluctuation. Periods may become irregular rather than stopping in a neat, predictable way.

It can take time to recognise

Some women have obvious symptoms. Others are only diagnosed after fertility concerns or after periods have been absent for some time.

At a glance

  • POI refers to ovarian insufficiency before age 40.
  • Between 40 and 45 is often described as early menopause.
  • Symptoms may overlap with menopause and perimenopause.
  • Because it happens earlier, long-term planning and support are especially important.

Possible symptoms or signs of POI

POI can affect women differently. Some women notice obvious symptoms, while others mainly notice missed periods, fertility difficulties or just not feeling like themselves.

Irregular periods
Absent periods
Hot flushes
Night sweats
Sleep disruption
Mood changes
Brain fog
Vaginal dryness
Difficulty conceiving

Wondering if this could be affecting you?

If you are noticing symptoms and are not sure whether they may be related to perimenopause or menopause, our tools can help you take the next step.

Related stages and topics

Understanding the wider menopause transition can help make symptoms and timing easier to make sense of.

Not sure where you are in the menopause transition?

You do not need to work it out on your own. Our pathway is designed to help you better understand your symptoms and take the next step with confidence.

Step 1

Symptoms Checker

Start with a quick check of the symptoms you are experiencing.

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Step 2

Questionnaire

Complete a more detailed questionnaire to explore your symptoms further.

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Step 3

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Speak with a menopause-focused clinician about treatment and support options.

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