An Evidence-Based Approach to the Management of Primary Ovarian Insufficiency in Adolescents and Young Women

Primary ovarian insufficiency (POI) in adolescents and young women is a rare but serious endocrine disorder with far-reaching reproductive, metabolic, and psychological implications. This study aimed to evaluate diagnostic timelines, treatment patterns, and psychosocial outcomes among affected individuals in a secondary care setting in Saudi Arabia. A retrospective observational analysis was conducted on 96 patients aged 13-39 years diagnosed with POI between 2018 and 2024. Data were extracted from electronic medical records and assessed using validated clinical and psychological tools, including the MENQOL and HADS. The mean age at diagnosis was 22.9 years, with one-third of patients experiencing diagnostic delays exceeding 18 months. Hormone replacement therapy was initiated in 69.8% of cases, while fertility counselling and bone mineral density screening were provided to 61.5% and 74.0% of patients, respectively. Over 60% exhibited clinically significant symptoms of anxiety or depression. Multivariate analysis revealed that delayed diagnosis, absence of hormone therapy, and lack of fertility counselling significantly increased the risk of psychological distress. These findings underscore the importance of timely diagnosis, multidisciplinary intervention, and integrated mental health support in the management of POI. Comprehensive, culturally responsive care models are essential to improving quality of life and long-term outcomes in this vulnerable population.