title: Spanish consensus on premature menopause.
abstract: BACKGROUND
  While we recognise that the term premature menopause is more accepted by most non-specialist health care providers and by the general population, 'primary ovarian insufficiency' (POI) is currently considered the most apposite term to explain the loss of ovarian function, because it better explains the variability of the clinical picture, does not specify definitive failure, and highlights the specific ovarian source. Its pathogenesis involves a congenital reduction in the number of primordial follicles, poor follicle recruitment, or accelerated follicular apoptosis. However, its cause is unknown in most cases.
  
  
  OBJECTIVE
  This guide analyses the factors associated with the diagnosis and treatment of POI and provides recommendations on the most appropriate diagnostic and therapeutic measures for women under 40 years of age who experience POI.
  
  
  METHODS
  A panel of experts from various Spanish scientific societies related to POI (Spanish Menopause Society, Spanish Fertility Society, and Spanish Contraception Society) met to reach a consensus on these issues.
  
  
  RESULTS
  Hormonal therapy (HT) is considered the treatment of choice to alleviate the symptoms of hypoestrogenism and to prevent long-term consequences. We suggest that HT should be continued until at least age 51, the average age at natural menopause. The best treatment to achieve pregnancy is oocyte/embryo donation. If a patient is to undergo treatment that will reduce her fertility, she should be informed of this issue and the available techniques to preserve ovarian function, mainly vitrification of oocytes.
authors.affiliation: University of Granada, Obstetric and Gynecologic, Granada, Spain. Electronic address: nicomendoza@telefonica.net.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Mendoza
authors.affiliation: Hospital Universitario la Fe de Valencia, Spain. Electronic address: ljulia@ono.com.
authors.forename: Ma Dolores
authors.initials: MD
authors.lastname: Juliá
authors.affiliation: Instituto Valenciano de Infertilidad (IVI), Barcelona, Spain. Electronic address: daniela_galliano@yahoo.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Galliano
authors.affiliation: University of Madrid (Complutense), Obstetric and Gynecologic, Hospital Clínico San Carlos, Madrid, Spain. Electronic address: pcoronadom@sego.es.
authors.forename: Pluvio
authors.initials: P
authors.lastname: Coronado
authors.affiliation: Complejo Hospitalario Universitario de Albacete, Spain. Electronic address: bego_delanoval@hotmail.com.
authors.forename: Begoña
authors.initials: B
authors.lastname: Díaz
authors.affiliation: Hospital Virgen de las Nieves de Granada, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Fontes
authors.affiliation: Hospital Virgen de las Nieves de Granada, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Gallo
authors.affiliation: Instituto Valenciano de Oncología, Spain. Electronic address: anagarcialloret@yahoo.es.
authors.forename: Ana
authors.initials: A
authors.lastname: García
authors.affiliation: Hospital Clinic Barcelona, Spain. Electronic address: mguinot@santpau.cat.
authors.forename: Misericordia
authors.initials: M
authors.lastname: Guinot
authors.affiliation: Sant Feliu de Llobregat, Barcelona, Spain. Electronic address: meritxell@munmany.com.
authors.forename: Merixtell
authors.initials: M
authors.lastname: Munnamy
authors.affiliation: Hospital Universitari Mutua Terrassa, Spain. Electronic address: brocacomella@gmail.com.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Roca
authors.affiliation: Hospital Materno-Infantil de Canarias, Spain. Electronic address: manuelsosamarrero@gmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sosa
authors.affiliation: Hospital Universitari Mutua Terrassa, Spain. Electronic address: jtomassaguer@gmail.com.
authors.forename: Jordi
authors.initials: J
authors.lastname: Tomás
authors.affiliation: University of Oviedo, Obstetric and Gynecologic, Hospital Central de Asturias, Spain. Electronic address: pllanezac@hotmail.com.
authors.forename: Plácido
authors.initials: P
authors.lastname: Llaneza
authors.affiliation: Clínica Diatros, Barcelona, Spain. Electronic address: rschez.borrego@diatros.com.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sánchez-Borrego
mesh_terms: D000328:Adult; D032921:Consensus; D019924:Embryo Disposition; D015914:Estrogen Replacement Therapy; D005260:Female; D005298:Fertility; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D008594:Menopause, Premature; D018587:Oocyte Donation; D009865:Oocytes; D006080:Ovarian Follicle; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012955:Societies, Medical; D013030:Spain
keywords: Fertility preservation; Fertility treatments; Hormonal therapy; Osteoporosis; Premature menopause; Primary ovarian insufficiency