Across a 22-year period, Malick et al. (2026) analysed medical records from large hospitals in Saudi Arabia. Of the 22,000 women who underwent follicle-stimulating hormone (FSH) testing, a diagnostic method for POI, 1,132 met the diagnostic criteria for POI.
The key findings were:
1) Approximately 36% of women with a POI diagnosis received hormone treatment.
2) Differences in hormone treatment prescription were observed based on POI type; for example, women who underwent genetic testing had the highest proportion of hormone treatment use, whereas iatrogenic cases (relating to illness caused by medical treatment, such as surgical removal of the ovaries) had a 0% prescription rate.
3) The absence of menstrual bleeding (amenorrhea) was the primary symptom driving POI diagnosis.
4) Symptoms, such as hot flushes and genitourinary symptoms (relating to the genital and urinary organs), were not associated with hormone treatment prescription in POI.
5) The authors reported that only 20-50% of women with osteoporosis or osteopenia, conditions associated with reduced bone density, had evidence of hormone treatment use.
6) Other long-term health consequences of POI were not consistently reported in medical documentation. Given existing evidence on the impact of prolonged hypoestrogenism (low oestrogen levels) on long-term health and symptom burden, the proportion of women who did not receive hormone treatment is concerning.
Recent research provides insight into how diagnosis and treatment of POI vary across healthcare systems and populations. Hormone therapy is under- prescribed in women with POI, leaving many at risk of preventable long-term health consequences.
Overall, this research highlights that hormone treatment after a POI diagnosis is often under-prescribed, leaving many women at risk of preventable long-term health consequences. While the study reflects healthcare practices in the Middle East and North Africa region, the gaps it identifies are relevant for women with POI everywhere.
Turning research into self-advocacy:
· Understanding your POI diagnosis, including type of POI can be used to promote personalised care and identify risks.
· The current ESHRE guidelines for POI can help you and healthcare professionals recognise what care is recommended, including on long-term health, and support conversations with your healthcare provider.
· Ask questions about hormone treatment: What are the benefits for long-term health, including bone and heart health? Could symptom management be improved? Are there barriers to accessing hormone therapy in my region?
https://doi.org/10.1097/gme.0000000000002739