Primary ovarian failure and menopause are the reasons for pathological and physiological decline in ovarian function. Epidemiology of POF is mainly unknown with very little population based studies. Primary ovarian failure is a heterogeneous disorder with a multicausal pathogenesis. A diagnosis of impending POF should always be lined out in every woman with an intermenstrual interval of > 90 days or with less than nine cycles every year. Laboratory tests contain karyotyping, FMR1 premutation testing, and hormone analysis. Use of hormone replacement therapy (HRT) for 3 years or more helps to reduce fracture risk in POF. Estrogen replacement or gonadotropin-releasing hormone analogs resulting in adequate FSH suppression followed by ovulation initiation with gonadotropins may complete pregnancy in very small percentage of women with POF. Management of general health of postmenopausal women is more and more important. Amelioration of short-term menopausal symptoms, as added benefit, was also realized. But this trend was not based on strong clinical evidence.