Table 1.

Recommendations for women who experience premature or early menopause

The results of the Women’s Health Initiative trials do not apply to women who have experienced early or premature menopause

Women experiencing menopause prior to age 45 (as a result of primary ovarian insufficiency or bilateral salpingo-oophorectomy) benefit from hormone therapy not only for vasomotor symptom management, but also for prevention of adverse cardiovascular, bone and neuro-cognitive effects related to premature estrogen deficiency

Several medical societies recommend that hormone therapy should be considered at least until the natural age of menopause for women experiencing early or premature menopause

Higher doses of estrogen (at least the equivalent of 100 µg of transdermal estradiol) may be needed to approximate blood estradiol concentrations similar to those of menstruating women

Women with primary ovarian insufficiency have a 5–10% chance of spontaneous conception and require appropriate counseling about contraception if pregnancy is not desired

Although testosterone has been shown to improve sexual function in women, it is not currently routinely recommended in women with primary ovarian insufficiency or bilateral salpingo-oophorectomy

Counseling regarding bone health includes recommendations for weight-bearing exercise, muscle strengthening, fall risk assessment, smoking cessation and avoidance of excess alcohol intake, along with a daily dietary intake of 1200 mg of calcium and 600–1000 IU of vitamin D, including supplements if needed

Women with primary ovarian insufficiency or bilateral salpingo-oophorectomy may benefit from psychological support to help address issues associated with early menopause including loss of fertility, changes in self-image, and sexual dysfunction