PREMATURE MENOPAUSE
Ø Premature menopause / Premature Ovarian Failure / Premature ovarian insufficiency is the loss of function of the ovaries before age of 40.
Ø A commonly cited triad for the diagnosis is amenorrhea, hypergonadotropinism, and hypoestrogenism.
Causes:
The cause of POF is usually idiopathic
· Genetic abnormalities: Chromosomes including sex chromosomes may be abnormal. Sex chromosomes abnormalities include Turner’s syndrome and disorders that confer a Y chromosome (which normally occurs only in males).
· Autoimmune disorders: the body produces abnormal antibodies that attack the body’s tissues, including the ovaries. Examples are thyroiditis, vitiligo, and myasthenia gravis.
· Metabolic disorders: Addison’s disease.
· Viral Infections: Mumps is an example
· Chemotherapy for cancer
· Radiation Therapy
· Surgical removal of the ovaries: Surgery to remove the uterus (hysterectomy) ends menstrual periods but does not cause menopause as long as the ovaries are functioning.
· Toxins e.g., tobacco.
Classification:
There are two basic kinds of premature ovarian failure.
1. Where there are few to no remaining follicles – causes includes genetic disorders, auto immune damage, chemotherapy, radiation to the pelvic region, surgery, endometriosis and infection.
2. Where there is abundant number of follicles – one frequent cause is auto immune ovarian disease which damages the maturing follicles, but leaves the primordial follicles intact.
Symptoms:
· Irregular or skipped periods (Amenorrhea), which may be present for years or may develop after a pregnancy or after stopping birth control pills.
· Night sweats
· Hot f lashes
· Vaginal dryness
· Irritability or difficulty in concentrating.
· Decreased sexual desire
Diagnosis
Premature menopause is suspected when women younger than 40 have menopausal symptoms. A pregnancy test is done, and levels of oestrogen and follicle-stimulating hormones are measured on several occasions to confirm the diagnosis.
Treatment
Estrogen and other therapies used during natural menopause are used to treat symptoms.
Ayurvedic perspective
· Pitta Kshayam
· Artava Agni Kshayam
· Aggrevation of sheeta guna in the dhatus, so pitta cannot sustain. Ultimately this leads to dhatvagnimandhya.
Medication
Snehapanam
Dose should be fixed after proper assessment of patient balam.
· Dhanwantara Vasti pakam – vata pitta haram
· Shatahwadi tailam – kaphaharam
· Sahacharadi vasti pakam – yoni visheshatvam
Swedanam
· Jambheera panda Swedam
· Pizhicchil
Virechanam
Dose: 25 gm (Along with hot water at 9.30 AM)
· Kalyanaka Gulam
· Sukumara Eranda Tailam
Vasti
Kshara Vasti (C.D 73/29-31)
DRAVYAM
|
QUANTITY
|
Meltfiltered)
|
100 gm
|
Lavanam
|
15 gm
|
Sneham murcchita tila tailam can be added
|
100 ml
|
Shatahwa kalkam
|
15 gm
|
Gomutram
|
400 ml
|
Total QTY
|
600 ml
|
Nasya Kalpana
Dose: 2 drops in each nostril
· Shadbindhu Tailam
· Shirovirechana Tailam
Shamana Chikitsa
Kashaya Kalpana
Dose: 60 ml b.d half an hour before food.
· Chitraka Grantyadi kashayam
· Kalyanakam Kashayam
· Saptasaram kashayam
· Kanashatahwai kashayam
Choorna Kalpana
Dose: 5 gm b.d with kulattha Kwatha/hot water
· Hinhguvachadi choornam
· Vaishwanara choornam
Vati / Gulika Kalpana
Dose: 2 b.d after food.
· Rajapravartini vati
· Chandraprabha vati
· Hinguvachadi vati
· Sivagulika
Arishta/Asava Kalpana
Dose: 25 ml b.d after food.
· Lakshmanarishtam
· Panchakolasavam
· Lohasavam
· Kumaryasavam
Ksharam/Bhasma Kalpana
Dose: 3 gm with honey
· Kalyanaka Ksharam
· Avilthodhadi bhasmam
When pitta gets aggrevated,
· Avipathi choornam – 5 gm bd after food.
· Shatavari gudam – 10 gm b.d with milk after food.
· Shatavari Ksheera kashayam – 60 ml at 6 pm in the evening.
