Gynäkologische Endokrinologie · Oct 2, 2026
Premature ovarian insufficiency – Updates on diagnosis and treatment from the S3 guideline Perimenopause and postmenopause – Diagnosis and interventions of the Association of the Scientific Medical Societies in Germany (AWMF)
By Böttcher B, Strowitzki T, Toth B
SUMMARY: Premature ovarian insufficiency (POI) is defined by menstrual cycle disturbances and elevated levels of follicle-stimulating hormone (FSH). The causes are diverse and range from genetic and autoimmune diseases to surgery and gonadotoxic therapies. Despite extensive diagnostic evaluation, no risk factor is identified in a large proportion of patients, and idiopathic POI is therefore diagnosed. Affected women may present with typical climacteric symptoms, but they may also be asymptomatic. As a consequence of long-term estrogen deficiency, untreated POI leads to a decrease in bone density, potentially resulting in osteoporosis, and to increased morbidity and mortality due to an increased cardiovascular risk. To restore an age-appropriate hormone supply, hormone therapy is indicated until the physiological onset of menopause (at approximately 52 years of age). Attention must also be paid to the psychological burden in order to strengthen coping mechanisms as well as compliance. This article aims to provide an overview of the treatment of POI in accordance with the S3 guideline “Perimenopause and postmenopause – Diagnosis and interventions” of the Association of the Scientific Medical Societies in Germany (AWMF). For further details, readers are referred to the thematic issue “Premature ovarian insufficiency” in Volume 24, Issue 1, February 2026 of Gynäkologische Endokrinologie (Springer Medizin).