Managing the psychological sequelae of POI

Abstract

Premature ovarian insufficiency (POI) is a life-altering, emotionally charged diagnosis for a 1–3% of young women. Those with spontaneous premature ovarian insufficiency particularly consistently report being confronted with the shock of a completely unexpected diagnosis and confusion about the cause which currently remains largely unidentified. Even where the cause is known as in the result of medical treatment, premature ovarian insufficiency is associated with negative stereotypes of menopause and aging; the stigma of not being able to conceive unaided; anger, depression and anxiety from being robbed of choice coupled with worries over bone density, cardiovascular risk and an uncertain future. This adversely impacts self-esteem, the ability to form and maintain relationships, particularly intimate ones. In addition, premature ovarian insufficiency women report difficulty in getting a timely diagnosis and targeted treatment often from primary care practitioners who themselves are under confident in this area. Crucially, premature ovarian insufficiency is more than infertility: physical and emotional health need to be addressed prior to discussion of plans for creating a family. With better understanding of the psychological sequelae of premature ovarian insufficiency, primary care practitioners have the potential to improve both medical and psychological outcomes for this growing group in women’s health.