Quality standard
Quality statement 3: Managing premature ovarian insufficiency
Quality statement 3: Managing premature ovarian insufficiency
Quality statement
Women, trans men and non-binary people registered female at birth with premature ovarian insufficiency are offered hormone replacement therapy (HRT) or a combined hormonal contraceptive.
Rationale
Women, trans men and non-binary people registered female at birth 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, this population 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
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
Proportion of women, trans men and non-binary people registered female at birth 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, trans men and non-binary people registered female at birth with premature ovarian insufficiency.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.
Outcome
Long-term health effects (for example, osteoporosis or cardiovascular disease) in women, trans men and non-binary people registered female at birth with premature ovarian insufficiency.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.
What the quality statement means for different audiences
Service providers (primary and secondary care) ensure that systems are in place for women, trans men and non-binary people registered female at birth 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, trans men and non-binary people registered female at birth with premature ovarian insufficiency unless contraindicated (for example, in women, trans men and non-binary people registered female at birth with hormone-sensitive cancer).
Commissioners ensure that they commission services in which women, trans men and non-binary people registered female at birth with premature ovarian insufficiency are offered HRT or a combined hormonal contraceptive.
Women, trans men and non-binary people registered female at birth 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: identification and management. NICE guideline NG23 (2015, updated 2024), recommendation 1.7.6
Definitions of terms used in this quality statement
Premature ovarian insufficiency
Menopause occurring before the age of 40, 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, full guideline glossary]