Management
Management is specific to the underlying condition and includes specialist referral to a gynaecologist and/or an endocrinologist as appropriate. The main aims for treatment are to restore fertility if desired, treat the underlying pathology and prevent complications of hormone deficiency. In POI, either HRT or a combined hormonal contraceptive) reduces the risk of chronic diseases, including cardiovascular disease and osteoporosis. For symptomatic prolactinoma, cabergoline is the first-line treatment. If pregnant, it is important to review medications as many are contraindicated, such as lithium, which is teratogenic and may cause hypothyroidism.
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