Quality statement 3: Managing premature ovarian insufficiency

Quality statement

Women with premature ovarian insufficiency are offered hormone replacement therapy (HRT) or a combined hormonal contraceptive.

Rationale

Women with premature ovarian insufficiency should be offered sex steroid replacement with either HRT or a combined hormonal contraceptive unless contraindicated (for example, because of hormone-sensitive cancer). Without treatment, these women can experience the effects of menopause for most of their adult life. This can lead to reduced quality of life and an increased risk of developing osteoporosis and cardiovascular disease, which can lead to early mortality.

Quality measures

Structure

Evidence of local arrangements to ensure that women with premature ovarian insufficiency are offered HRT or a combined hormonal contraceptive.

Data source: Local data collection.

Process

Proportion of women with premature ovarian insufficiency who receive HRT or a combined hormonal contraceptive.

Numerator – the number in the denominator receiving HRT or a combined hormonal contraceptive.

Denominator – the number of women with premature ovarian insufficiency.

Data source: Local data collection.

Outcome

a) Health-related quality of life for women with premature ovarian insufficiency.

Data source: Local data collection.

b) Long-term health effects (for example, osteoporosis or cardiovascular disease) in women with premature ovarian insufficiency.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (primary and secondary care) ensure that systems are in place for women with premature ovarian insufficiency to be offered HRT or a combined hormonal contraceptive.

Healthcare professionals (such as GPs, practice nurses and healthcare professionals with expertise in menopause) offer HRT or a combined hormonal contraceptive to women with premature ovarian insufficiency unless contraindicated (for example, in women with hormone-sensitive cancer).

Commissioners (clinical commissioning groups and NHS England) ensure that they commission services in which women with premature ovarian insufficiency are offered HRT or a combined hormonal contraceptive.

Women with early menopause (also known as premature ovarian insufficiency) are offered either HRT or the combined contraceptive pill to help relieve their symptoms if these treatments are suitable for them.

Source guidance

Menopause (2015) NICE guideline NG23, recommendation 1.6.6

Definitions of terms used in this quality statement

Premature ovarian insufficiency

Menopause occurring before the age of 40 years, which is also known as premature ovarian failure or premature menopause. It can occur naturally or as a result of medical or surgical treatment.

[NICE's guideline on menopause, terms used in the guideline]