We mentioned earlier that the main treatment modality for premature ovarian failure is hormone replacement therapy. The aim of treatment, as with menopausal syndrome, is mainly to relieve symptoms such as those caused by estrogen deficiency in ovarian failure (e.g. hot flashes and night sweats) and, more importantly, to prevent long-term complications (e.g. osteoporosis, cardiovascular disease, progeria, etc.). Will long-term hormone replacement therapy have side effects or cause cancer? Many patients are concerned that if I start hormones before I am 40 years old, will there be many side effects? It is true that the once synthetic hormones may increase the incidence of hypertension, hyperlipidemia, and blood clots. However, after the advent of natural hormones, this situation has been reversed, and there are studies that prove that natural hormone supplementation does not increase the risk of hypertension and has a hypolipidemic and hypoglycemic effect. In patients with premature ovarian failure who have a uterus, they are mostly treated with a combination of estrogen and progestin, where the role of progestin is to avoid excessive proliferation of the endometrium. Therefore, patients with uterus need to use hormone replacement therapy, and the incidence of endometrial cancer in combination with progestin is lower than that in patients without hormone use. The effect of hormone replacement therapy on the development of breast cancer is still debated, and most experts believe that a course of treatment not exceeding 15 years will not increase the incidence of breast cancer. Patients with premature ovarian failure benefit more from hormone therapy Because women with premature ovarian failure are at higher risk for cardiovascular disease and osteoporosis, they can benefit more from hormone replacement therapy. Therefore, treatment for patients with premature ovarian failure should be continued until the normal average age of menopause – around 55 years. Patients need to have regular follow-up physical examinations during treatment, which include mammograms (see “Menopause hormone therapy must be reviewed regularly to adjust medication” for more information). Doctors will help patients manage their risks. Will the hormone levels in my body be too high after taking the medication? Some patients are also concerned about how the dosage of hormones is set and whether the estrogen level in the body will be too high. The principle of hormone therapy for premature ovarian failure is to maintain the baseline level of hormones in the patient’s body with the smallest dose that can relieve the symptoms, which can achieve the purpose of relieving the symptoms as well as maintaining the stability of bone metabolism and glucose and lipid metabolism. For example, if you take 1mg of Glivec, the estrogen level in human body will increase by 20~30pg/ml on average, while the estrogen level in early follicular phase of women of reproductive age is about 40pg/ml, so it will not cause excessive hormone level in human body. In addition, patients with premature ovarian failure are relatively young and have strong metabolic ability, so it is still safe to use hormone replacement therapy.