Summary table of investigations

Updated on 12 Dec 2023
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Summary of investigations to consider in women with premature ovarian insufficiency (POI). Some of these investigations would be arranged in secondary care.

Tests
1. FSH levels.	Serial measurements are required for diagnosis (two blood samples taken 4–6 weeks apart). For more information, see diagnosis section.
2. Adrenal cortex or 21-hydroxylase antibodies.	Recommended blood test where cause of POI is not known.
3. Thyroid peroxidase autoantibodies.	Recommended blood test where cause of POI is not known.
4. Tests for other linked autoimmune conditions such as RA, IBD, coeliac's disease and type 1 diabetes.	It should be checked if clinically indicated.
5. Prolactin, LH, estradiol, testosterone and TSH levels.	NICE says testing may be helpful for the diagnostic workup.
6. Referral for chromosomal analysis.	Recommended where the cause of POI is not known. Where resources are limited prioritise in women <30 years, those with learning difficulties or those with a family history.
7. DEXA scan.	It should be undertaken in all women at baseline. Repeat DEXA scans may be required for monitoring.
8. BP and weight.	CVS risk should be assessed and monitored in all women.

References and Further Information:

Management of the Menopause. Sixth edition. Hillard T, Abernethy K, Hamoda H et al. British Menopause Society. BMS Management of menopause 2017.
Panay N, Anderson A, Nappi R et al. Premature ovarian insufficiency: an international society white paper. Climacteric 2020.
ESHRE full guidance. Management of women with premature ovarian insufficiency. Guideline of the European Society of Human Reproduction and Embryology. POI guideline development group. 2015.
NICE CKS guidance. Diagnosis. Diagnosis of premature ovarian insufficiency. Last revised September 2022.

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