Premature Ovarian Failure V Menopause
That all important meeting has just started and a wave of heat suddenly comes out from nowhere starting from your feet to your head, and no amount of flapping of papers in front of you can suppress the rush of heat. You do as much as you can to maintain composure, and calm the irritation of emotions that are welling up inside.
These are symptoms that many can understand and especially those who are peri menopausal and in the later stages of menopause.
Menopause is the most natural transformation for women as they approach 50 years of age and a time when reproduction slows and fertility ceases due to the natural decline of follicles and eggs. The physical and emotional changes for some is overwhelming, especially with thoughts that you can no longer bare a child naturally, whilst facing the grace of acceptance that your body cannot produce anymore eggs.
However, in clinic we are treating more women in their late twenties and early thirties with menopausal like symptomology of hot flashes, night sweats, irregular periods and mood swings that are all indicative of menopause. However, for younger women the terms used are, premature ovarian failure or early menopause and poor ovarian reserve.
Premature ovarian failure occurs when your ovaries stop functioning before the age 40 due to little or no eggs, or for some the ovary function fails to produce follicles and eggs. This problem can develop during the teenage years, or could have been present from birth.
In some cases, the condition can develop after pelvic surgery or due to cancer treatment of radiation and chemotherapy, with some instances of premature ovarian failure being temporary.
1 in every 1000 women between the age of 15 – 29, and 1 in every 100 of 30- 39 year olds are diagnosed with premature ovarian failure. Investigations with the use of blood tests that check levels of Anti-Mullerian, Follicle Stimulating and Estrogen hormones can confirm diagnosis. But what does this really mean? How many follicles or eggs are left, and what are your chances of conceiving?
What happens to my eggs?
A woman is born on average of 2 million ovarian follicles. As she gets older and reaches puberty, follicles have already started to decline and she will have about 300,000-400,000. It is these follicles that mature into eggs, but not every follicle will become a mature egg. For each egg that matures and released, at least 500 to 1,000 do not fully mature and are re-absorbed by the body. By the late forties there are only several thousand eggs remaining. Unlike other cells in the body, egg cells do no replicate themselves and the body does not make anymore.
When the cycle begins, estradiol levels are low and the body sends out signals to release follicle stimulating hormone (FSH).
This FSH triggers a few of your follicles to develop into mature eggs but only one follicle will be the lucky one to become a mature egg. As the follicles mature they send out another hormone, estrogen. Estrogen sends a message to stop producing FSH.
If the follicles do not mature and produce estrogen to stop the production of FSH, FSH will continue to produce and rise to high levels. This is what happens during the stages menopause and one of the reasons why your FSH levels are important to IVF clinics to assess your response to egg stimulation process of IVF and help with a diagnosis of primary ovarian failure.
Some women may continue to have normal periods and show no symptoms. Diagnosis may only be discovered when the FSH levels are measured and come back with elevated levels when pregnancy hasn’t happened after trying for a while.
What Are My Options?
Once diagnosed with primary ovarian failure, conventional medical approaches for those wanting to have a family include IVF if your ovarian reserve levels are not too low or your FSH levels high, donor egg or adoption is advised.
None of these options are easy, and in my opinion IVF should be considered carefully due to the increased stimulation of existing follicles and eggs when undergoing the IVF process. There is limited or no research to suggest or confirm that IVF reduces ovarian reserve or expedites menopause but in clinical practice we have seen a further decline in ovarian reserve soon after IVF. One could argue that symptoms are a result of medication or natural progression, but more research is required to help identify the effects of IVF and ovarian reserve.
It is not impossible to conceive naturally with premature ovarian failure although important to find ways that help improve your body, mind and lifestyle needs to help deal with the stress effects on your body as well as helping enhance the quality of eggs you have left.
This is the focus on many natural treatments and certainly the focus of our treatment program using an integrated approach of conventional and Traditional Chinese Medicine (TCM) concepts. It is through these concepts that we continue to see improvements in egg and lining quality with improved AMH and FSH levels whilst helping the body’s immune function and therefor chances of pregnancy.
Natural and Alternative Treatments
Many women are using alternative and complementary therapies as an adjunctive or primary aid for many hormonal imbalances such as PCOS, menopause and premature ovarian failure. However, we must also consider that for some egg donor and adoption may be the only options to start or extend their family.
Therefore, is important that you find a specialist who has experience and credibility who understands the benefits and constraints of natural therapies for women with premature ovarian failure. Natural treatments can aid in the management of symptoms and in some cases have shown natural pregnancy outcomes against the odds.
Using TCM nutrition to help manage hormones and help improve egg quality is beneficial in the planning and preparation for pregnancy either naturally or alongside IVF treatments. Many gynecology and fertility colleagues are always amazed when blood results show improvements in AMH, FSH and estradiol levels along with good pregnancy outcomes for our shared patients.
To have the exact nutrition that complements your body needs will require a consultation with a fertility expert in the field of TCM with perhaps some conventional medical fertility knowledge, as a clear understanding of your fertility needs would be required for an individual and unique approach to treatment.
However, premature ovarian failure or menopause in TCM terms will usually have a diagnosis that indicates a deficiency of Yin, Blood, or Jing essence either in their own right or all three elements together as they are all Yin in substance. In most cases foods are advised that can nourish these elements within the body, which can also be related to foods that have a higher water content. These include;
Yin Nourishing Foods
Apple, Asparagus, Avocado, Banana, Blueberry, Barley, Cheese, Crab, Crayfish, Duck, Egg, Honey, Kidney Bean, Lemon, Malt, Mango, Milk, Mulberry, Mushrooms, Nettle Tea, Oysters, Peas, Pear, Pineapple, Pomegranate, Pork, Peppermint Tea, Royal Jelly, Rice, Seaweed, Sesame, Spelt, Spinach, String beans, Sweet Potato, Tomatoes, Watermelon, Yam
Jing Nourishing Food
Almond, Artichoke, Bone Marrow, Chicken, Egg, Kidney, Liver, Microalgae, Mussels, Walnuts.
Blood Nourishing Food
Apricot, Beef, Beetroot, Bone Marrow, Cherry, Chicken, Dates, Fig, Grapes, Kale, Kelp, Leafy Greens, Liver, Microalgae, Mussel, Nettle, Octopus, Oxtail, Oyster, Parsley, Sardine, Seaweed, Spinach, Stout, Watercress.
The British Medical Journal published a review in 2008 outlining the effects of acupuncture alone during fertility treatment and found that genuine or classic acupuncture had increased women’s chances of pregnancy when used alongside assisted reproductive treatments such as IVF.
According to traditional Chinese medicine, the needles unblock energy (or chi) and increase blood flow to promote a state of balance in the body. According to conventional medicine, acupuncture needles stimulate the nervous system to release chemicals that help tissue repair and healing as well as its relaxing affects.
When treating infertility issues, acupuncture helps improve blood supply to reproductive organs, stimulate hormones, regulate ovulation, and decrease stress — all of which is seen to help increase your chances of getting pregnant.
For this reason, acupuncture is one of the most popular and well researched natural fertility treatment recommended by clinicians in the field of reproductive medicine for both men and women.
Fertility massage is a slow, deep abdominal massage that realigns the uterus, reproductive and abdominal organs.
The techniques encourage many important factors such as general well-being, relaxation but most of all decreasing scarring, pelvic adhesions and increasing the function of the reproductive organs.
Fertility massage is designed not only to increase the flow of blood to the uterus, ovaries and fallopian tubes, but also to increase a sense of well-being, strengthen the immune system, balance hormones, and improve the health of the lymphatic system. The result of all this is increased chances of conceiving either with your own or donor eggs.
When being faced with primary ovarian failure or early menopause, every woman has different needs and you must remember you only need one good egg and there are many ways that can help achieve this, despite egg numbers declining. It is also fair to say that egg donor and adoption are options to help start or extend your family which should be a consideration for some. Menopause at any stage of a woman’s life can be difficult to accept and come to terms with, and primary ovarian failure or early menopause is no exception.
Although more research is required for the use of natural medicine for the treatment of fertility, there is growing evidence and outcomes that natural treatments has its place to enhance pregnancy outcomes naturally and alongside assisted procedures for the many causes of infertility. Whether you understand its concepts or not, many of those who undergo natural treatments have stories to tell that baffles most and goes beyond the science as we currently know it.
Despite being difficult to understand, natural therapies can bridge the gap of your fertility health needs and improve your body’s natural responses where science has its limits.