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Premature Ovarian InsufficiencyPhase 3NCT06851754

Hormone Replacement Therapy in Adolescents With Premature Ovarian Insufficiency

A Phase 3 study testing Progesterone and Estrogen Patch in people with Premature Ovarian Insufficiency, run by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Background: Premature ovarian insufficiency (POI) is a condition in which women under the age of 40 years have absent or irregular menstrual cycles. POI can cause infertility, signs of menopause, osteoporosis, and other symptoms. Read more about this study

Who is it for?
Ages 11 to 19 years, women onlyHealthy volunteers can take part
Conditions the study is for
Premature Ovarian Insufficiency
What is being tested?
Progesterone and Estrogen Patch
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
185 participants
Where
1 siteUnited States
Study dates
17 Jul 2025to 31 Dec 2031
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 11 to 19 years
  • Women only
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • To be eligible to participate in this study, an individual must meet all the following criteria:
  • Individuals aged 11-19 years, inclusive, at the time of enrollment.
  • Diagnosis of premature ovarian insufficiency.
  • Documentation of one elevated serum FSH measurement greater than the testing laboratory's upper reference range (for age/Tanner stage).
  • Identify as female (i.e., sex assigned at birth)
  • Negative pregnancy test.
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  • Individuals aged 11-19 years.
  • Identify as female (i.e., sex assigned at birth)
  • Negative pregnancy test.
  • Absence of known chronic disease

Who cannot join

  • Male participants are excluded from both study groups (POI and Healthy Volunteers) as POI affects only the female reproductive system, while pregnant participants are not eligible to have DXA or HRpQCT imaging for safety reasons.
  • An individual who meets any of the following criteria will be excluded from participation in this study:
  • POI in the setting of Turner syndrome.
  • Patients who screened positive for celiac disease.
  • Receipt of any medications including HRT determined by the investigator to affect bone metabolism 3 months prior to enrollment.
  • Any medical condition determined by the investigator to affect bone health will be excluded.
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  • Presence of a medical, psychiatric, or social condition which, in the opinion of the investigator, would place undue burden on the subject, NIH resources, or increase risk of participation.
  • Report of sexual activity but refusal to use a copper intrauterine device or double barrier forms of contraception during the study.
  • For healthy volunteers, all exclusion criteria will apply as for POI participants except for number 1.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Catherine M Gordon, M.D. contact

(301) 827-5449

catherine.gordon@nih.gov

United States1 site, 1 recruiting
  • National Institutes of Health Clinical Center

    Bethesda, Maryland, 20892

    NIH Clinical Center Office of Patient Recruitment (OPR), 800-411-1222 ext. TTY dial 711, ccopr@nih.gov

    Recruiting

Other trials in United States

About this study

Background:

Premature ovarian insufficiency (POI) is a condition in which women under the age of 40 years have absent or irregular menstrual cycles. POI can cause infertility, signs of menopause, osteoporosis, and other symptoms. Hormone replacement therapy (HRT) is a treatment that gives women extra hormones, such as estrogen and progesterone. HRT works well in adult women. Researchers want to find the most effective doses and regimens for adolescents.

Read more

Objective:

To monitor the effects of HRT on adolescents with POI.

Eligibility:

Female adolescents aged 11 to 19 years diagnosed with POI. Healthy volunteers are also needed.

Design:

All participants will have clinic visits every 6 months for 2 years. Each visit may last 2 days. Each visit may include:

Blood and urine tests.

A test of their heart function.

A test to measure the stiffness of their blood vessels. Participants will lie flat with a blood pressure cuff on a leg and a meter on the neck while the cuff inflates.

A test of their grip strength. Participants will squeeze a handheld device as hard as they can.

Two scans to measure bone density. For one, participants will lie on a table while a scanner passes along their body. For the other, participants will sit in a chair and insert their forearm, then their lower leg, into a scanner.

A test to measure skin pigmentation. Participants' skin will be touched lightly with a device.

An optional visual exam of the vagina. Some vaginal fluid may also be collected with a cotton swab/cytobrush.

Participants with POI will receive HRT. They will be given estrogen patches and progesterone pills.

Read the detailed description

Study Description:

This is a study of adolescents with premature ovarian insufficiency (POI) and their response to hormone replacement therapy (HRT).

Objectives:

Primary:

To identify the phenotype and associated genotype of adolescents with POI at the time of diagnosis, including assessment of overall bone health of participants pre- and post-HRT treatment with respect to bone mineral density (BMD) and other skeletal endpoints.

Bone Health:

-Follow patients with POI for bone health assessments:

  • Measure BMD at different skeletal sites, including the central skeleton (lumbar spine, total body less head, and hip - femoral neck and total hip)
  • Perform vertebral fracture assessment (VFA)
  • Determine body composition of lean body and fat mass (total body) and correlate with BMD.
  • Assess skin pigmentation and muscle grip strength and correlate with BMD

Secondary:

Bone Health

-Follow patients with POI for bone health assessments:

  • Measure BMD at peripheral skeleton (radius and tibia)
  • Evaluate bone microarchitecture and strength of the radius and tibia.

Metabolic Phenotype:

  • Follow patients with POI for metabolic assessment:
  • Insulin resistance
  • Cardiovascular risk
  • Lipid profiles
  • Bone turnover

Muscle Phenotype:

-Follow patients with POI for muscle function assessment:

  • Determine hand grip muscle strength
  • Evaluate lean body mass (by DXA) to determine muscle mass

Cardiovascular Health

-Follow patients with POI for a cardiovascular evaluation:

  • Electrophysiologic parameters (from 12-lead EKG)
  • Arterial stiffness (by Pulse Wave Velocity, PWV)
  • Coagulation studies to determine the impact of HRT on clotting function

Genetic profiling:

-If obtained, assess the baseline genotype of patients with POI to correlate with BMD and other health outcomes

--If subjects are co-enrolled on NIAID protocol 17I0122, utilize that genetic sequencing data to associate with genotype and response of multiple health outcomes to HRT.

Quality of Life:

-Follow patients with POI for evaluation of an individual s perception of their life quality and health:

  • Evaluate the individual s perceived occupational performance in self-care, productivity, and leisure
  • Evaluate the individual s occupations or hobbies that align with their interests

Psychological health:

-Follow patients with POI for evaluation of an individual s mood and well-being:

  • Measure symptoms and severity of depression
  • Measure the state and trait components of anxiety

Menopause profile:

-Follow patients with POI for determining signs and symptoms of menopause:

  • Evaluate reproductive hormonal changes
  • Assess menopausal symptoms and their severity
  • Evaluate vaginal health

Hormone Replacement Therapy:

-Follow patients with POI longitudinally to determine the most effective HRT management:

  • Evaluate dosage, delivery, combination of HRT
  • Evaluate effects of HRT on bone, cardiovascular, metabolic, gynecologic, and psychological health

Endpoints:

Primary:

Longitudinal evaluation of BMD of the central skeleton (lumbar spine).

As secondary measures of bone health, dual-energy x-ray absorptiometry (DXA) measures of skeletal sites other than the spine (DXA - hip/total body) will be evaluated longitudinally in POI participants and their BMD compared to healthy control participants. Using DXA, vertebral fractures assessment (VFA) will be performed in POI participants and compared to healthy control participants. In addition, BMD will be evaluated with respect to skin pigmentation and muscle grip strength.

Secondary:

  • High-resolution peripheral quantitative computed tomography (HRpQCT) bone density and strength measures by HRpQCT of the peripheral skeleton (radius and tibia) will be evaluated longitudinally in participants with POI and their BMD compared to healthy control participants.
  • Compare metabolic and cardiovascular parameters in participants with POI to healthy controls.
  • Compare muscle phenotype in participants with POI to healthy controls by measuring muscle strength using hand grip dynamometry and measuring lean body mass (as measure of total body muscle mass) by DXA.
  • Compare repolarization changes (by 12-lead EKG), arterial stiffness (by PWV) and coagulation parameters in participants with POI to healthy controls.
  • Compare genetic background of participants with POI to healthy controls using whole genome sequencing.
  • Evaluate quality of life with Canadian Occupational Performance Measure (COPM) and Interest Checklist questionnaires.
  • Evaluate psychological health of participants with POI compared to healthy controls using the Beck Depression Inventory and Spielberger State/Trait Anxiety Inventory.
  • Evaluate menopausal profile in participants with POI compared to healthy controls by detecting changes in ovarian hormonal levels and correlating with responses on the Menopause Rating Scale, and vaginal cytology and degree of atrophy after HRT compared to baseline (and participants vs. controls).
  • Compare health effects from a typical clinical HRT regiment over the course of 2 years of administration.
Being tested
Progesterone, Estrogen Patch
Keywords
Premature Ovarian Insufficiency, Hormone Replacement Therapy, Adolescents, Bone Health
Medical subject headings
Primary Ovarian Insufficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ProgesteroneDrug

    Oral micronized progesterone will be added (100 mg/day for 12 days/month) in the event of spontaneous vaginal bleeding and/or at 12 months over the 2-year protocol.

  • Estrogen PatchDrug

    participants with POI (n=85) will receive transdermal 17 beta-estradiol (beginning at a dose of 25 microgram/patch applied weekly), with the dose increased at 3 months to 50 microgram, and thereafter every 6 months to 75 and 100 microgram/patch for pubertal induction or estrogen replacement (with 100 microgram/patch representing a full adolescent or young adult estradiol dose). The continued escalation of the estradiol dose and patch strength will be guided by the clinical presentation and physical examination (by the PI or designated AI).

Study groups in NCT06851754
Study groupRoleWhat they receive
Healthy ParticipantsNo interventionHealthy Control Participants
POI PatientsExperimentalPOI patients will be receiving transdermal 17 beta-estradiol and oral micronized progesterone.
Receives: Drug: Progesterone; Drug: Estrogen Patch

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Longitudinal evaluation of BMD of the central skeleton (lumbar spine).

    measures of bone health, dual-energy x-ray absorptiometry (DXA) measures of skeletal sites other than the spine (DXA - hip/total body) will be evaluated longitudinally in POI participants and their BMD compared to healthy control participants. Using DXA, vertebral fractures assessment (VFA) will be performed in POI participants and compared to healthy control participants. In addition, BMD will be evaluated with respect to skin pigmentation and muscle grip strength.

    Measured: 2 years

Secondary outcomes (9)
  1. Evaluate bone density and strength of the radius and tibia in participants with POI and compare with healthy controls.

    Bone Health - Evaluate bone density and strength of the radius and tibia in participants with POI and compare with healthy controls.

    Measured: 2 years

  2. Compare metabolic and cardiovascular parameters between participants with POI and healthy controls.

    Metabolic Phenotype - Compare metabolic and cardiovascular parameters between participants with POI and healthy controls.

    Measured: 2 years

  3. Assess muscle strength and lean body mass in participants with POI compared to healthy controls.

    Muscle Phenotype - Assess muscle strength and lean body mass in participants with POI compared to healthy controls.

    Measured: 2 years

  4. Analyze heart repolarization, arterial stiffness, and coagulation parameters in participants with POI versus healthy controls.

    Cardiovascular Health - Analyze heart repolarization, arterial stiffness, and coagulation parameters in participants with POI versus healthy controls.

    Measured: 2 years

  5. Compare the genetic background of participants with POI to healthy controls using whole genome sequencing.

    Genetic profiling - Compare the genetic background of participants with POI to healthy controls using whole genome sequencing.

    Measured: 2 years

  6. Assess quality of life using COPM and Interest Checklist questionnaires.

    Quality of Life - Assess quality of life using COPM and Interest Checklist questionnaires.

    Measured: 2 years

  7. Evaluate psychological health using the Beck Depression Inventory and Spielberger State/Trait Anxiety Inventory.

    Psychological Health - Evaluate psychological health using the Beck Depression Inventory and Spielberger State/Trait Anxiety Inventory.

    Measured: 2 years

  8. Compare menopausal profile, including ovarian hormone levels and responses to the Menopause Rating Scale, between participants with POI and healthy controls.

    Menopausal profile - Compare menopausal profile, including ovarian hormone levels and responses to the Menopause Rating Scale, between participants with POI and healthy controls.

    Measured: 2 years

  9. Assess health effects of a typical clinical HRT regimen over two years.

    Hormone Replacement Therapy - Assess health effects of a typical clinical HRT regimen over two years.

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Feb 2025
  2. Study start17 Jul 2025
  3. Primary completion1 Dec 2031 (estimated)
  4. Study completion31 Dec 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
185 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06851754
Sponsor's protocol ID
10002141
Other IDs
002141-CH
Status last verified
27 Oct 2026
First submitted
25 Feb 2025
Last updated
29 Oct 2026
Results posted
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: All IPD that underlie results in a publication will be deposited into a data repository in line with NIH regulations.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Progesterone and Estrogen Patch in people with Premature Ovarian Insufficiency, run by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 29 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Catherine M Gordon, M.D. ((301) 827-5449, catherine.gordon@nih.gov), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Longitudinal evaluation of BMD of the central skeleton (lumbar spine). (time frame: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Oct 2026.

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