This is the failure of ovarian function prior to 40 years of age. The pituitary hormone which stimulates the ovary to produce follicles (FSH) is high, but the ovary does not respond and consequently the serum estradiol levels are low. Periods are typically scant and rare. Some of the women with this condition may have occasional ovulation and sometimes can conceive. The incidence is 1 in 1000 at age 30 and 1% at 40 years of age.

Because bone turnover is effected by estrogen status there is a higher incidence of osteopenia and osteoporosis. Hot flashes, night sweats are seen and there is often painful intercourse due to vaginal dryness secondary to relative estrogen deficiency. Some patients also have low thyroid and adrenal function. There could be an associated eating disorder.

Some of the patients are prone to excessively exercise. In most situations emotional support is needed to help cope and deal with the infertility related issues. Hormonal supplementation can help compensate some of the deficiency symptoms, but fertility is not feasible.