Ovarian failure

Types

Premature ovarian failure

• Also called Primary ovarian insufficiency, premature menopause
• POF is a primary ovarian defect characterized by primary amenorrhea or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea).
• It is a heterogeneous disorder affecting approximately 1% of women <40 years
• The most severe forms present with absent pubertal development and primary amenorrhea, whereas forms with post-pubertal onset are characterized by secondary amenorrhea associated with premature follicular depletion.
• As in the case of physiological menopause, POF presents by typical manifestations of climacterium: Infertility associated with palpitations, heat intolerance, flushes, anxiety, depression, fatigue.

• Beyond infertility, hormone defects may cause severe neurological, metabolic or cardiovascular consequences and lead to the early onset of osteoporosis.
• Heterogeneity of POF is also reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects.

Triad of diagnosis:

• Amenorrhea,
• Hypergonadotropism: High levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea)
• Hypoestrogenism: Low levels of gonadal hormones (estrogens and inhibins)

Causes

• Idiopathic in 90%
• Auto immune:
  • Autoimmune oophoritis: MMP
  • Hashimoto thyroiditis: EBV, MMP, HCV
  • Addison disease
  • Type I diabetes mellitus
  • Pernicious anemia: Atrophic Gastritis : EBV or HCV
• Other causes include chemotherapy, being a carrier of the fragile X syndrome gene, radiotherapy, Cigarette smoking, higher body mass index, racial and ethnic factors, illnesses, and the removal of the uterus.
• Genetic disorders such as Turner syndrome and Fragile X syndrome, metabolic defects, and enzyme defects.

Secondary ovarian failure

• In secondary OF, ovaries are normal but there is a problem getting hormone signals to them from the brain.
• This is usually caused by diseases of the pituitary gland or hypothalamus. (Hypopituitarism)
• It may also caused by certain medicines, too much exercise, or certain eating disorders.
• Some women with secondary ovarian failure sometimes have menstrual periods and may be able to have children.
• Hypogonadotropic hypogonadism

Miasms

• Primary ovarian failure: Oophoritis (FSH / LH is normal) : MMP
• Secondary ovarian failure: (FSH / LH increased) Hypopituitarism (MTB), Hashimoto thyroiditis (MMP, HCV, EBV), Addison disease (MTB, HSV-1, EBV)
• Central Hypogonadism (Prolactin increasing, Genicomastia): HCV

Remedies

Sep 200

• Sepia occupies the top position among the Homeopathic medicines for treatment for anovulation.
• The menstrual symptom for Sepia is late and scanty menses.
• In most of the cases, this is accompanied by bearing down sensations in the pelvic region.
• The ovaries remain enlarged with fluid-filled cysts in them.
• Sepia acts very efficiently to regulate the menstrual cycle to appear at the proper expected time.
• Sepia can also be considered to treat infertility cases due to PCOS.
• Face hirsutism, esp on upper lips, can also be well controlled with Sepia
• Sensitivity to cold air, Mental irritability, and Indifferent behavior towards loved ones.

Puls 30

• Anovulation esp due to PCOS cases in females who suffer from suppressed periods for a long duration.
• Menses are very scanty and extremely painful
• Esp in young girls at puberty who suffer from PCOS with irregular periods.
• Total absence of thirst and a desire for cool open air.
• Open air overall seems to provide relief to the patient.
• Mild, sensitive nature with weeping tendencies.
• She weeps at the slightest instance and feels somewhat better when given consolation

Calc 200

• PCOS with anovulation and is particularly suited when a woman with PCOS
• Profuse periods that are prolonged more than the usual duration
• Weight gain and obesity
• Excessive sweating on the head
• Extreme sensitivity to cold air
• Peculiar craving in eating habits like a desire for boiled eggs and in a few cases, strange things like chalk and lime.

Nat-m 200

• Anovulation who have irregular and suppressed menstrual cycles
• Difficulty in conception due to PCOS
• Excessively hot sensation, aversion to heat of sun
• Craving for extra salt in the diet
• Reserved nature of patient, weeping spells especially when alone and worsening of symptoms when sympathy is offered.

Thuj 200

• Retarded menstrual flow with multiple cysts in ovaries
• Abnormal growth / cysts or accumulation anywhere in the body
• Most women requiring Thuja have cystic growths more pronounced in the left-side ovary.
• Extreme hair growth on unusual parts in women due to hormonal imbalance.

Kali-c 30

• Anovulation  when the menses are suppressed altogether for several months.
• Backs and legs give out. Violent backache , relieved by sitting and pressure.

Senec 30

• Menses are suppressed but the woman feels that menses are about to come.
• Symptoms related to menses are present like heaviness or pain in pelvis region and nausea, but the menstrual flow is absent.

Apis 3x

• Anovulation due to cyst.
• Menses suppressed with cerebral and head symptoms.
• There is bearing down sensation as if menses were to appear.

Lach 200

• Anovulation, Menses too short, too feeble.  
• Cyst in the left ovary with pain.
• Pain is worse in the morning.
• Pains are all relieved by the flow.

Thyr 30

• Thyrodinum is also effective remedy for treating anovulation due to thyroid dysfunction.