Consider blood tests to exclude other causes
FSH levels two occasions >4 weeks apart (> 25 IU/l on two occasions).
Normal levels do not exclude POI and should not delay treatment.
FBC, TFT, coeliac screen, B12, folate, ferritin, HbA1c. Consider 21OHAb (adrenocorticol antibodies)
Total testosterone and SHBG to calculate FAI
This resource is aimed at women experiencing menopausal symptoms who are above the age of 45. Please select the higher age bracket to review the benefits and risks of starting HRT, most of which is applicable also to women under the age of 45.
Most of the available clinical evidence for HRT comes from studies of women starting HRT around the age of natural menopause, but women who undergo early menopause or who have been diagnosed with premature ovarian insufficiency benefit greatly from HRT as well.
Because of the low risk of endometrial cancer (Mirena coil in situ or hysterectomy in the past), estrogen-only HRT in the form of transdermal estrogen is recommended.
Continued use of HRT carries some potential risks, which are explained below. Each array is composed of 100 women, meaning one person is equivalent to 1%. Use the toggle buttons to compare no HRT and HRT usage for 5 or 10 years.
Because of the small risk of endometrial cancer, endometrial protection is
Continued use of combined HRT carries some potential risks, which are explained below. Each array is composed of 100 women, meaning one person is equivalent to 1%. Use the toggle buttons to compare no HRT and HRT usage for 5 or 10 years.
The above risk estimates are from the national guidance provided Medicines & Healthcare products Regulatory Agency (MHRA). For more information, please click here
Do not commence hormonal treatment and consider referral to specialist services.
Information is sourced from NICE, RCOG, MHRA, and other published literature. No warrant is given that the module is free of errors, complete or up-to-date, and no information herein should be considered a substitution for medical expertise, experience and judgement. For feedback, please use the link above.