Hormone therapy underused in women with premature ovarian insufficiency

CLEVELAND, Ohio (Jan 21, 2026)—Women diagnosed with premature ovarian insufficiency (POI) are at risk for more health problems than women who enter menopause after the age of 40. Although hormone therapy has been shown as a treatment to mitigate some of these added risks, a new study concludes that it is underused in women with POI. Study results are published online today in Menopause, the journal of The Menopause Society.

Premature ovarian insufficiency is a clinical condition characterized by the loss of ovarian function in women aged younger than 40 years. Women with POI are not only affected by symptoms associated with estrogen deficiency, but they also are also at increased risk for long-term adverse health consequences, such as infertility, osteoporosis, cardiovascular disease, cognitive impairment, dementia, sexual dysfunction, and mood disorders that can significantly affect their quality of life.

A previous systematic review and meta-analysis estimated the global prevalence of POI at 3.5%, although its incidence has been increasing over the past 20 years. International guidelines suggest hormone therapy to help manage symptoms and reduce the long-term health risks of POI. However, multiple studies indicate that hormone therapy remains underused, with variations in initiation, type, and duration of therapy.

A new study involving more than 255,000 patients was conducted to help address the gaps in POI research. The primary objective was to determine the rate and patterns of hormone therapy use among women diagnosed with POI and to identify demographic and clinical factors associated with hormone therapy initiation. Secondary objectives included estimation of the percentage of women diagnosed with POI among those who underwent follicle-stimulating hormone (FSH) testing and determination of the percentage of women aged younger than 40 years who underwent FSH testing, a simple blood test designed to assess reproductive health.

Researchers documented that the POI prevalence in tested women was 5.05%. Of these, only 36% of women with POI received hormone therapy. Amenorrhea (the absence of menstrual periods) was the most common presenting symptom at 42.4%. Hormone therapy uptake remained low despite diagnoses of osteopenia (6.8%) and osteoporosis (4.9%).

Based on the numbers, the researchers concluded that hormone therapy is underused in women with POI. Although the study was conducted in Saudi Arabia, and it has been proven that regional differences exist in hormone therapy use, a number of credible organizations, including the National Institutes of Health, have confirmed that hormone therapy is also significantly underused by women with POI in the United States. The researchers suggest that this underuse is largely because of provider and patient lack of knowledge and misconceptions and fears about risks related to hormone therapy, despite the treatment having proven useful in the prevention of long-term complications such as osteoporosis.

The findings of this study emphasize the requirement for necessary training in POI management and greater adherence to international guidelines that clearly recommend hormone therapy until the average age of natural menopause in this population.

Study results are published in the article “Use of hormone therapy in patients with premature ovarian insufficiency in tertiary hospitals in Saudi Arabia.”

“This study highlights real-world practice patterns and gaps in the care of women with POI. Patient and clinician education are key to filling some of these gaps and improving the global care of women with premature menopause,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

For more information about menopause and healthy aging, visit www.menopause.org.

The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.