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Key points

• Premature ovarian insufficiency (POI)/ failure (premature menopause) is loss of ovarian function before age 40 years. Early menopause is menopause before age 45 years.
• Chemotherapy/ radiotherapy causes POI due to impaired follicular maturation and/or direct primordial follicle loss.
• The extent of damage depends on the age and pre-treatment ovarian reserve of the woman, type of drug or radiation field and cumulative dose.
• Amenorrhoea may be permanent or temporary with subsequent development of POI/ early menopause.
• Currently there is no reliable biochemical predictor of menopause.
• The most effective and established means of preserving fertility in young women are oocyte and embryo cryopreservation prior to starting treatment. Treatment with GnRH agonists can decrease the risk of POI but impact on fertility is less clear