Premature menopause is characterized by amenorrhea, elevated gonadotropin levels and sex steroid deficiency occurring in women below 40 years of age. Heterogeneity of premature ovarian failure is reflected by various causes, both spontaneous and iatrogenic. X chromosomal abnormalities remain the main cause of primary ovarian insufficiency. Women with primary ovarian insufficiency present with amenorrhea, irregular cycles, signs of estrogen deficiency and infertility. They are at increased risk for non-communicable diseases such as, cardiovascular disease, Alzheimer's disease, and osteoporosis. Management includes use of menopausal hormone therapy till the age of natural menopause and customized as per the needs. In women having fertility issues, IVF with donor oocytes remains the treatment of choice with the best results. With advances in assisted reproductive technologies, cryopreservation of oocytes/embryos should be utilized, whenever impending primary ovarian insufficiency is anticipated either due to therapy or biological reasons.
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