What is the role of hormone therapy in POI?

• A. Used only for fertility preservation
• B. Used only to treat osteoporosis
• C. Recommended until average age of menopause to replace hormones
• D. Not recommended in POI

Answer: (C)

In POI, estrogen production drops, which drives hot flashes, vaginal dryness, bone loss, and potential cardiovascular changes. Hormone therapy provides the body’s missing hormones in a way that mirrors normal physiology. The plan is to replace estrogen (and add a progestin if the uterus is present) and to continue this replacement until the age when natural menopause would typically occur. By doing so, it helps relieve symptoms, protects bone health, and may reduce other long-term risks associated with estrogen deficiency. It’s not limited to fertility concerns; fertility preservation is not the primary role of this therapy. The goal is to maintain a more normal hormonal milieu until the usual menopause age, at which point the need for therapy is reassessed. If someone cannot take systemic estrogen, alternatives exist, but the standard approach in POI is ongoing hormone replacement until the expected age of menopause.