In many women it has taken a long time for the diagnosis of POI to be made. Many people, including health professionals, may attribute having irregular or periods to other things such as stress, weight changes or other gynaecological conditions such as polycystic ovarian syndrome, without appropriate investigations.
It is currently recommended that further investigations should be carried out if you periods have stopped or become infrequent for around 4-6 months.
Investigations
If you present with these symptoms, tests your GP may consider include:
Follicle stimulating hormone (FSH) levels: This is done by a blood test which should be taken on day 2-5 of the menstrual cycle or at any time if you are not having periods. If FSH levels are elevated within the menopausal range they should be repeated again after 4-6 weeks to confirm a diagnosis of POI
Luteinizing hormone (LH) levels: Usually done at the same time as the FSH test, these are also elevated in POI.
Pelvic ultrasound scan: This may be done if your health professional wants to exclude other causes for your symptoms. It can also be useful to count the number of follicles in the ovaries as this is low in POI.
Once the diagnosis is suspected or confirmed some of the following investigations may be performed either by your GP or following referral to a hospital specialist:
Genetic testing: blood tests to look for an underlying genetic cause may be considered particularly in women who develop POI at a very young age of with a strong family history.
Antibody screening: a blood test to look for adrenal and thyroid antibodies is often performed as POI can occur in combination with autoimmune conditions
Bone density scan: Also known as a DEXA (dual energy x-ray absorptiometry) scan. This may be recommended to assess your risk of osteoporosis at the time of diagnosis, and may be repeated again in 3-5 years, particularly if you are not using HRT.
Read the latest NICE guidelines here.
