TABLE 4

Premature ovarian insufficiency (POI) causes and risk factors

Classification by cause
Idiopathic (90% of cases)
Genetic
 Monosomy X (Turner syndrome)
 Fragile X premutation (fragile X mental retardation 1 [FMR1]) carrier
Autoimmune
 Isolated
 In association with polyglandular failure
Iatrogenic
 Cancer treatment with chemotherapeutic agents, stem cell transplantation, or pelvic radiation (exposure > 10–12 Gy highest risk)
 Bilateral salpingo-oophorectomy
Risk factors for POI and early menopause
Family history (menopause before age 46 in mother, sister, aunt, or grandmother)
Smokinga
 Earlier onset of menopause
 Increased prevalence and severity of vasomotor symptoms
  • aIn the Canadian Longitudinal Study on Aging,2 which examined multimorbidity risk in POI, 15.5% of women in the POI group smoked vs 7.3% in the group who experienced menopause at an average age.

  • Based on information from references 4 and 5.