Premature ovarian insufficiency: why is it not being diagnosed enough in primary care?

How good are we in primary care at diagnosing and managing premature ovarian insufficiency (POI)? Unfortunately, not very, as this condition is still underdiagnosed and undertreated. Many GPs have not heard of this condition and admit to not being confident diagnosing it. POI is very common; it affects 1% of women under 40 years and 0.1% of women under 30 years in the UK.1 Interestingly, 2.5% of all patients with POI are adolescents. One reason for an increasing incidence in this condition is that there is increased survival from childhood cancers and many of these women have received radiotherapy and chemotherapy, often resulting in adverse effects on their ovarian function. POI is defined as a loss of ovarian activity before the age of 40 and is characterised by irregular or absent periods and reduced fertility. Symptoms of oestrogen deficiency often occur, which include hot flushes, …