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Premature Ovarian Failure and HRT

Q: I am a 31-year-old woman who was diagnosed with premature-ovarian failure (POF) at the age of 19. I've pretty much been on HRT ever since. I do have osteoporosis and arthritis already and i don't know if I should still be taking HRT.

When I spoke with my nurse practitioner about all of the new information that has come out she told me that she feels sorry for me because they don't really know what to tell me. I am confused and frightened. Everything I was told to do to stay healthy I am now hearing could cause more problems.

From what I know I am the youngest known woman with premature menopause and they don't have enough answers for me. I have 6 children and I want to be healthy for them for a very long time.


Dr. Donnica:
Thanks for contacting me.  As a mother, I can certainly sympathize with your desire to be there for your children for as long as possible!  As you can imagine, since I don't know you personally, I can't give you medical advice via the internet.  I can recommend, however, that it may be time for you to consult a gynecologist about this issue.  What I can also tell you is that the Women's Health Initiative study which was just in the news DID NOT evaluate women with POF or anyone near your age.  These women, on average, were 63 years old.  The average age of onset of POF is 27.  There is no way for us to extrapolate information from the WHI to a young woman in your very different circumstances. 

I can also tell you that in my opinion, these study results should not be broadly interpreted to mean "Ok, everyone stop taking HRT unless you have menopausal symptoms."  Each woman has a different risk benefit ratio that should be discussed with her physician and sorted out on an annual basis. 

There is no one right or wrong answer here.  I do not recommend that any woman currently taking HRT make any snap decisions about her therapy based upon this news.  I do recommend that any woman having questions about how this news applies to her should speak with her healthcare provider (which you have done) and review her own personal risk-benefit profile. 

As always, I recommend that all women in their 40's and above have an annual physical exam, an annual mammogram, and an annual Pap smear with a rectal exam, whether or not they take HRT.  During your annual visit, you should review all current medicines, including non-prescription products and supplements, with your physician.   When you consult a physician, you may wish to discuss other medicines, which you may take in addition to HRT to help treat your osteoporosis and arthritis.

Please also read our complete news alert on this topic, NIH Stops Trial of Estrogen Plus Progestin Due to Increased Breast Cancer Risk and our article on POF.

With best regards,
Donnica L. Moore, MD
President, DrDonnica.com

Created: 7/16/2002  -  Donnica Moore, M.D.

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