Premature Ovarian Insufficiency (POI) diagnosis and treatment

[Stella Hurtin]

Hi, I am 36 year old who has just been diagnosed with POI. My blood tests showed varying FSH levels over 3 tests (34, 21, 29) and LH (18, 15, 13), oestrodiol (100, 142, 111). My AMH is 1.9.
I have very low bone density, an ultrasound ruled out PCOS, and I have lots of perimenopausal symptoms (disturbed sleep, bouts of anxiety and depression, fatigue, sore breasts, urinary issues, abdominal weight gain of 10kg in the last year or so). I am lucky to have one child and would like to have another.

I have had two periods in the last year, one just after having my Mirena IUD out a year ago, and one almost a year later in June this year, just after stopping breastfeeding (which I was only doing occasionally and had no elevated prolactin).

My endocrinologist has prescribed Estradot patches (100mcg) and Utrogestan capsules (200mg 12 days on 16 days off) and said I should not go down the natural route as I will inevitably end up on HRT given my AMH level and that I need HRT for bone health. I also spoke to a naturopath who specialises in treating POI naturally and said she could get my cycles going again using herbs, supplements and natural treatments. This would take at least 3 months and be financially costly. She would not elaborate on the likely treatment until I am further down the track despite knowing the above info. She thought I should try the natural route for fertility reasons and she generally thought it was better to be cycling naturally rather than going on HRT in my case.

Lara or anyone else who has been through this, I would love some advice on whether it is better to go on HRT straight away or give the natural option a go, given my situation. Of course the choice is mine and I don't expect anyone to make it for me, I am just struggling to reconcile the two positions or find someone who can assess both and give me some guidance on how to choose.
Thanks in advance.