Nutritional Therapies for Premature Ovarian Insufficiency (POI) and Menopause
What is Premature Ovarian Insufficiency?
Premature ovarian insufficiency is a reproductive disorder that has systemic effects and can significantly reduce quality of life as well as increase the risk for various other health issues. It is defined by a decrease in the production of estrogen from the ovaries, and in turn, this causes an increase in the production of gonadotropins from the pituitary gland (follicle stimulating hormone and luteinizing hormone). The reduction in estrogen levels increases the risk of issues with cholesterol levels, reduced bone density (osteoporosis), cardiovascular disease, genitourinary issues, sleep disorders, mood disorders and infertility.
Who does POI affect?
It is estimated to affect approximately 1% of the general population. Some studies have found a correlation that Patients with a lower body mass index (BMI) are more likely to have POI. POI can also be caused due to genetic background, Patients with Mothers who had early menopause may have a lower ovarian reserve as well.
What causes POI?
POI can be caused due to genetics, a side effect from certain medical treatments or as a result of immune system dysregulation.
Can Nutrients help with POI?
There is some research that has found that higher protein consumption may help to postpone menopause. One study found that consumption of seafood 3x a week and eggs at least 4x a week was correlated with a delayed onset of menopause. Additional studies have also suggested that higher protein intake is associated with prolonging reproductive function and delaying ovarian ageing. Researchers suggested that adequate protein consumption may be a potential intervention to help reduce POI progression and severity, however, larger studies are warranted.
Vitamin E has been studied to increase ovarian volume and stimulates growth of the follicles/eggs. In one study, administering Vitamin E to Patients with POI for 3 months was associated with increased antral follicle count (AFC), increasing ovarian volume and increasing levels of anti-mullerian hormone (AMH - a hormone marker for ovarian reserve).
Probiotics and Prebiotics
The gut microbiome is an essential source of additional estrogen for the body. The component of the gut microbiome that is responsible for estrogen metabolism is referred to as the estrobolome. One study combined probiotics with phytoestrogens and it was found to alleviate genitourinary symptoms and its efficacy was comparable to the current gold standard treatment (low dose vaginal estrogen).
Providing Patients with various strains of probiotics was also associated with improved glucose metabolism reduce the risk of urinary tract infections.
Prebiotics (fermented dietary fibres) help feed the gut microbiome. And their consumption drives improved calcium absorption and has a protective role in preventing osteoporosis in menopause. The prebiotics lower the pH of the gut lumen by increasing production of lactic, acetic and propionic acids which increase absorption of calcium in the gut lumen.
Consumption of prebiotics was also associated with improved blood sugar control and cholesterol levels as well.
Combining prebiotics with phytoestrogens has been shown to improve absorption and bioavailability of phytoestrogens to help alleviate some menopausal symptoms.
This article is being shared as educational content and is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healthcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance and supervision.