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Welcome to the My 28 Days Newsletter! 

  • January 1, 2023
  • Doctor Lawrence

My 28 Days is an initiative designed to elevate the conversation around women’s menstrual and ovarian health. It serves as a comprehensive primary resource for women with primary ovarian insufficiency (POI) to find answers, community, and knowledge to make evidenced-based decisions about their health and care. Thank you for subscribing and becoming part of our community!

We’ll use this monthly bulletin to share the latest research and resources on POI – from treatments to expert advice. Starting with our next issue, we‘ll address your most pressing questions in a special feature column. Know someone with POI who might benefit from this information? Please forward this on to them and encourage them to subscribe. Be sure to follow us on Instagram, Facebook and/or LinkedIn to stay up to date on the latest in women‘s health.

What is POI?

Although primary ovarian insufficiency (POI) is not fully understood by the medical community, our goal at My 28 Days is to continue to bring to light what the research uncovers. First and foremost, it’s important to clarify two facts: 1) POI is a hormone deficiency and 2) treatments can help.

POI is a rare condition in which the ovaries stop functioning as they should before age 40. When this happens, the ovaries fail to produce the typical amounts of the hormone estrogen or release eggs regularly. This condition can often lead to infertility. Although POI is sometimes confused with premature menopause due to the similarity in symptoms, these conditions are not the same. In POI, ovaries may periodically function, and then stop; and then start and stop again. Women with POI may have irregular or occasional periods for years and might even get pregnant, whereas menopause occurs when a woman’s body naturally stops producing the hormones that cause a menstrual period entirely. Restoring estradiol levels in women with POI to mimic their natural state helps prevent some complications that occur as a result of low estradiol. 

These conditions include:

  • Osteoporosis
  • Cardiovascular disease
  • Impaired sexual function
  • Anxiety and depression
  • Vision damage
  • Brain health
  • Other issues that might lead to a shortened life expectancy

Our goal at My 28 Days is to help you better understand the available effective treatments for POI — and offer some hope that POI is not a permanent obstacle to pregnancy or quality of life.

POI Fast Facts

  • POI is a hormonal deficiency.
  • POI is not menopause, rather it is a fluctuation of fertility and ovarian hormone cycles.
  • There are POI treatments available that have been proven to be safe and effective to relieve symptoms and restore health.
  • In about 10 percent of cases, the cause of POI can be determined by special testing; however, in most cases, the cause of POI remains a mystery.
  • There are steps women can take to optimize the chance of pregnancy when diagnosed with POI.
  • A small percentage of women with POI do get pregnant with their own eggs and have a healthy baby.
  • Often a simple blood test for follicle stimulating hormone (FSH) can determine if a woman has POI. FSH will be higher than normal in women whose follicles are no longer working to produce normal levels of estradiol in the blood. 

One of the early symptoms of the onset of POI is irregular or missed periods. As the disorder progresses and the hormonal deficiency worsens, other symptoms that resemble menopause may appear, including:

  • Hot flashes
  • Night sweats
  • Mood instability and irritability
  • Poor concentration and/or “brain fog”
  • Decreased libido
  • Painful intercourse
  • Vaginal dryness
  • Infertility

Understanding Ovarian Health and Hormones

Understanding POI begins with first understanding ovarian hormones. A woman’s reproductive system is a wonderfully complex system involving continuous communication between the brain and the ovary. The hypothalamus, pituitary, and ovary are the messengers that regulate the monthly cycle. Given the first sign of ovarian hormone complex is usually the loss of regular menstrual periods, it’s important to track your cycle’s regularity. We believe health care providers should treat women’s periods like a vital sign — when periods are regular it’s the sign that the ovaries and the whole endocrine system related to reproduction is working the way it should; when they are irregular, it’s important to uncover why.

In short, women who have POI are deficient in estradiol, a critical hormone typically present in a young woman’s blood. Evidence has shown the onset of estradiol deficiency early in life is associated with a shorter life expectancy — among other health concerns — which makes education, early diagnosis, and treatment of POI critically important.  

You could have ovarian hormone complex if:

  • Your menstrual cycles are erratic and unpredictable.
  • Your menstrual periods are less than 21 days or more than 35 days apart.
  • You have bleeding or spotting between cycles.
  • You skip periods (sometimes for months at a time).
  • You have had any of these symptoms in the past and were prescribed birth control pills with no testing to determine the cause of the abnormality.

Resources to Help

If these symptoms pose more questions, My 28 Days is here to offer hope — and help! Chances are your family doctor is not that well-versed when it comes to a rare disorder such as POI. In fact, even your OB/GYN may not be very familiar with POI. That‘s why we have created easy-to-understand printable PDFs — so you can educate and advocate when it comes to your menstrual and ovarian health. Visit our website here to download our PDF, “What is POI?” today.

In health,

Doctor Lawrence logo

Dr. Lawrence M. Nelson, MD, MBA
Director, My 28 Days® Initiative
President, Mary Elizabeth Conover Foundation, Inc.

Menstrual and Ovarian Health

Follow the Evidence

POI Fast Facts

POI is a hormonal deficiency. It is not menopause.

Read More

Know Your Numbers

Understanding estradiol deficiency begins with understanding ovarian hormones.

Read More

The Evidence

Research can help you make evidence-based decisions.

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Think Again

Educate and advocate. Your doctor may not be an expert.

Read More