Premature ovarian insufficiency: Updated concepts in diagnosis and hormonal treatment strategies

To provide an updated overview of Premature Ovarian Insufficiency (POI), focusing on the current evidence regarding diagnosis, hormonal treatment, and clinical management. A narrative review was conducted using data from the FEBRASGO protocol and updated international guidelines, complemented by recent publications from PubMed and Scopus. POI affects up to 3.5 % of women under 40-years of age and is associated with significant physical and psychological repercussions due to early hypoestrogenism. The diagnosis is established based on persistent amenorrhea and elevated FSH levels, and etiological diagnosis should be encouraged. Hormone Therapy (HT) is the cornerstone of management and must be continued at least until the age of natural menopause. New evidence emphasizes the use of l17β-estradiol (preferably non-oral route) combined with cyclic or continuous progestogens. Fertility preservation and sexual health should be addressed early in management. Hormonal replacement in POI is essential to prevent long-term complications and improve quality of life. Guidelines for healthy lifestyle habits should be reinforced and clinical decisions should be individualized, guided by age, symptom profile, and reproductive plans.