Dr Jodi Hart1, Dr Kirsty Fisher
1Fiona Stanley Hospital, Murdoch, Australia
Biography:
Jodi is a General Medicine advanced trainee with an interest in women's health and endocrinology.
Abstract:
A 32-year-old G5P3 Aboriginal woman was referred for evaluation of 12 months of secondary amenorrhoea and vasomotor symptoms. There was no history of autoimmune disease, cytotoxic exposure, or family history of premature ovarian insufficiency (POI). Follicle stimulating hormone (FSH) was 38 IU/L with oestradiol (E2) 496 pmol/L in May 2024. Repeat bloods January 2025 show FSH > 100IU/L and E2 <100pmol/L. Thyroid function was normal. Anti-adrenal cortex antibodies were negative. She was mildly anaemic with a haemoglobin of 110g/L. Pelvic ultrasound revealed normal ovaries and uterus. Further testing, including karyotype and Fragile X premutation analysis has been requested. Cyclical hormone replacement therapy was prescribed, with a plan to continue until usual age of menopause.
Premature ovarian insufficiency (POI), defined as the loss of ovarian function before age 40 years, affects approximately 1% of women under 40. It carries significant implications for fertility, cardiovascular and bone health, and psychosocial wellbeing. This case demonstrates a structured, guideline-based approach to POI, aligned with the updated 2024 Australasian Menopause Society guidelines. It highlights the importance of genetic evaluation for patients and their families, the use of hormone therapy, and proactive strategies to reduce long-term health risks associated with the condition.