Understanding Premature OvarianFailure& EarlyMenopause
AboutDr.Steven R.Goldstein
•LeadingMenopauseSpecialistNYC
•Over30yearsinprivategynecologicpractice
•Co-authorofTheEstrogenAlternative
•ExpertinHormoneReplacementTherapy (HRT),POF,andPOI
AsacertifiedmenopausepractitionerandpastpresidentofThe MenopauseSocietyaswellastheInternationalMenopauseSociety, DrGoldsteinhasworkedextensivelywithwomennavigatingthe complexitiesofearlymenopauseandPOIandcurrentlyseespatients athisEastsideManhattanoffice.
Whatis Menopause?
•Naturalcessationofovarianfunction
•AverageageintheU.S.is51.4
•Surgicalmenopauseoccursafterovaryremoval
•Widerangeofonset–somewomenmaintain functionintolate50s
Menopauseisanormal,biologicalphasewhere ovarianfunctionends.Ittypicallyoccursaround51, butDrGoldsteinhasseenpatientsnaturally producingestrogenwellintotheirlate50s.
WhatisEarlyMenopause?
••Occursbeforeage45 Occursbeforeage45
••Canbeemotionallyand Canbeemotionallyand psychologicallydistressing psychologicallydistressing
••Mayimpactfertilityandfamily Mayimpactfertilityandfamily planning planning
••Requirescarefulcounseling Requirescarefulcounseling andsupport andsupport
Earlymenopausecanbetraumatic, particularlyforwomenwhohavenot yetcompletedtheirfamilies.Emotional supportandclarityaboutremaining optionsarecriticalaspectsofcare.
Understanding
POF/POI
•Menopausebeforeage40
•ReferredtoasPrematureOvarianFailure(POF) orPrematureOvarianInsufficiency(POI)
•Oftenmisdiagnosedorunderdiagnosed
Ifmenopauseoccursbeforeage40,wedefineitas POForPOI.Theterm“insufficiency”isnowpreferredas ovarianfunctionmayfluctuate.Thisisdistinctfrom typicalmenopauseandrequiresatailoredapproach.
WhyPOIisDifferent
•POIpatientsmaystillhaveintermittentfunction
•Requiresindividualizedtestingandtherapy
•Notthesameasnaturalmenopauseat50+
•Hormoneneedsareoftenhigher
Unliketypicalmenopause,POIcanbeunpredictable. Thesewomenarenotjustyounger—theyhavedifferent hormonalneeds,whichmeansstandardmenopause treatmentoftenfallsshort.
HormoneReplacement Therapy(HRT)forPOI
•Stronglyrecommendedunless contraindicated
•Neededuntiltheaverage menopauseage(~51)
•Oftenhigherdosesrequiredthan intypicalmenopause
•Supportsbone,heart,brain,and sexualhealth
HormoneReplacementTherapyfor POIisnotoptionalinmostcases—it’s essential.Itreplaceswhatthebody wouldhavenaturallyproduced, protectinglong-termhealth.Thekey istomatchphysiologicallevelsseen intheiragegroup.
DrStevenR.GoldsteinisanHRT SpecialistinNYCandhasworked extensivelywithwomenwhohave POItohelpstabilizetheirhormone levels.DrGoldsteinhashelped thousandsofwomeninMenopause withhormonereplacementtherapy toalleviatetheirsymptoms.
UnderlyingCauses andTesting
•Screenforautoimmuneconditions (e.g.,thyroidantibodies)
•Genetictesting(Xchromosomeabnormalities)
•Fertilityassessmentandcounseling
•Customtreatmentplans
Athoroughworkupiscritical.ManyPOIcasesare autoimmune-related,orhavegenetic underpinnings.Testingguidesbothtreatment andfamilyplanningdiscussions.
TheImportanceof SpecializedCare
•POIisadistinctdiagnosisrequiringexpertcare
•Manyproviderstreatitliketypicalmenopause
•Dr.Goldsteinspecializesincomplexmenopausalcases
•Consultationcanhelpclarifydiagnosisandplan
Unfortunately,manycliniciansapplya“one-size-fits-all” menopausemodel.POIpatientsdeservemorespecialized attentiontoensureoptimaloutcomesforhealth,hormone balance,andfuturefertilityoptions.
ThankYou
Ifyoubelieveyoumaybeexperiencingsymptomsofearly menopauseorPOI,orhavequestionsaboutHRT,then perhapsaconsultationwithDrStevenR.Goldstein,a
MenopauseSpecialistNYCmaybeinorder