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Key points

• Premature ovarian insufficiency (POI) is loss of ovarian function before age 40 years. Early menopause is menopause occurring between ages 40-45 years.
• Chemotherapy/ radiotherapy causes POI due to ovarian follicle loss, impaired follicular maturation, and ovarian vascular/ stromal damage.
• The extent of damage depends on the age and pre-treatment ovarian reserve of the patient, type of drug, cancer type, radiation field/ type and cumulative dose.
• Amenorrhoea may be temporary or permanent with subsequent development of POI/ early menopause.
• Currently there is no reliable biochemical predictor of menopause.
• Hormone therapy is recommended unless contraindicated
• The most effective and established means of preserving fertility are oocyte/ embryo cryopreservation prior to starting treatment.