Filipa Rafael: A Woman Should Not Have to Be Trying for a Baby for Her Ovarian Insufficiency to Matter
Filipa Rafael, Founder and Scientific Director at Fertilidade em Foco (Fertility in Focus), shared on LinkedIn:
“A woman should not have to be trying for a baby for her ovarian insufficiency to matter.
Later this month, I’m returning to the Algarve to speak at the Conference of Gynecology and Obstetrics (Jornadas de Ginecologia e Obstetrícia), in Lagoa, about diagnosis, treatment and investigations before menopause.
This meeting has a special place in my professional life. I co-founded these Jornadas and AFIMBA, the association behind them. I’m proud to return to something I helped create, and to bring a subject I want us to take seriously in primary care.
For me, improving care for women with premature ovarian insufficiency (POI) in Portugal starts with a few very practical things:
- Recognise it earlier. Persistent absent or irregular periods in a woman under 40 deserve investigation, including consideration of POI. We should not wait for 12 months without a period to investigate.
- Know what we are diagnosing. POI occurs before 40; early menopause between 40 and 44 is a distinct category. For POI, current guidance uses at least four months of disordered cycles and FSH >25 IU/L, considering pregnancy and the effects of hormonal medication. Repeat FSH if the diagnosis is uncertain.
- Discuss treatment beyond symptom relief. In POI, hormone therapy is generally recommended until the usual age of menopause, even without hot flushes, with an individual assessment of contraindications and preferences.
- Make follow-up part of the plan: bone and cardiovascular health, sexual wellbeing, psychological support and reproductive counselling that respects what the woman wants.
A specialist referral should come with a clear shared plan: who follows what, when she is reviewed, and where she can turn with questions. The GP remains part of her care.
That is the conversation I want to have in Lagoa. Women with POI or early menopause deserve continuity of care, whether they want children, have completed their families or are still figuring out what this diagnosis means for them.
- Jornadas de Ginecologia e Obstetrícia
- 29–30 October
- Lagoa Congress Center.”

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