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Severe menopause symptoms often accompany premature ovarian insufficiency

Hot flushes, insomnia, and vaginal dryness are commonly reported symptoms that accompany the menopause transition. A new study suggests that such symptoms--especially psychological and sexual problems--are worse for women who have premature ovarian insufficiency (POI) than for women undergoing natural menopause. 

Premature ovarian insufficiency is defined as the cessation of ovarian function that leads to menopause before the age of 40 years. The condition is associated with increased risks for a number of long-term health comorbidities, including osteoporosis, cardiovascular disease, mood disorders, cognitive impairment, and sexual dysfunction. It can also lead to a shorter life expectancy.

Despite research around the various risk factors associated with POI, few studies have examined the effect of POI relative to the prevalence, severity, and factors affecting menopause symptoms. In this new study involving nearly 300 Chinese women, researchers specifically investigated menopause symptoms in women with POI and compared them with the severity and prevalence of similar symptoms in women who experienced natural menopause.

What they found was that women with POI experience a high prevalence of menopause symptoms, especially those in the psychological and sexual domains, and that these symptoms are often more severe than those experienced by women who undergo natural menopause. The symptoms likely to be most severe include mood swings, hot flashes, insomnia, fatigue, and sexual dysfunction (including vaginal dryness, dyspareunia, and decreased libido).

On the basis of these results, the researchers have suggested that healthcare providers be more cognizant of psychological complications and sexual dysfunction risks in women with POI and work with them to identify options for relief.


To comprehensively investigate and evaluate the prevalence, severity, and associated factors of menopausal symptoms in women with premature ovarian insufficiency (POI). In this study, the specific symptomatology experienced by women with POI and women with natural menopause was also compared.

In this cross-sectional study, 293 Chinese women with POI from an outpatient clinic were recruited between June 2014 and January 2019. The prevalence and severity of menopausal symptoms were assessed with modified Kupperman Menopausal Index. Participants completed a structured questionnaire, including medical history, menstrual characteristics, and sociodemographic data. Serum levels of reproductive hormones were measured.

Among 293 women with POI (33.76 ± 5.47 y), the most prevalent symptoms were mood swings (73.4%), insomnia (58.7%), sexual problems (58.7%), and fatigue (57.3%). Moderate-to-severe mood swings were most frequently reported (23.9%), followed by formication (17.4%) and hot flashes/sweating (17.1%). Compared with women with natural menopause, women with POI exhibited significantly higher risks for fatigue (odds ratio = 1.42; 95% confidence interval, 1.04-1.94), melancholia (3.12; 1.94-5.01), mood swings (3.57; 2.33-5.45), insomnia (1.41; 1.02-1.96), and significantly lower risks for moderate-to-severe sexual problems (0.40; 0.23-0.69), any and moderate-to-severe muscle/joint pain (0.41; 0.27-0.62 and 0.45; 0.25-0.78, respectively). Living in urban areas and higher gravidity were independently associated with menopausal symptoms in women with POI.

Women with POI experienced a high prevalence of menopausal symptoms, particularly related to psychological and sexual domains. Furthermore, women with POI tended to have more distressing menopausal symptoms compared with women with natural menopause.


Huang, Yizhou MD; Qi, Tongyun MD; Ma, Linjuan MD; Li, Die DPH; Li, Chunming MD; Lan, Yibing MD; Chu, Ketan MD, PhD; Chen, Peiqiong MM; Xu, Wenxian MM; Cao, Yina MB; Ying, Qian MPH; Xu, Ling MM; Zhou, Jianhong MD, PhD. Menopausal symptoms in women with premature ovarian insufficiency: prevalence, severity and associated factors. Menopause: January 18, 2021 - Volume Publish Ahead of Print - Issue -
doi: 10.1097/GME.0000000000001733

Content created 20 Jan 2021


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