Ladies, did you know that your ovaries can age faster than you do? While you just blew out 25 candles on your birthday cake, your ovaries are already choosing a retirement home. That’s right. In this week’s medical buzzkill, I bring to you premature ovarian ageing.

Any discussion about ovaries makes me uncomfortable. That’s mainly because I have been lugging around two massive chocolate cysts on each of mine for over 10 years (more on that later). Recently, I unwittingly learnt about ovarian ageing.

“But doesn’t every organ age?” you ask. They do. But from what I learnt, ageing of the ovaries is accelerated compared to other organs. It’s also the earliest-ageing organ, which pretty much starts declining in quality since birth.

Ovarian aging is considered as the pacemaker of female body aging, which drives the aging of multiple organs of the body.

I know, yikes! This is an excerpt from a 2019 study published in Impact Journal of Ageing titled “Can ovarian aging be delayed by pharmacological strategies?”

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What is ovarian ageing?

Dr Bharati Dhorepatil, Fertility Consultant, Nova IVF Fertility, Pune defines it: “Premature Ovarian Ageing can be termed as a poor ovarian reserve in younger women relative to what is expected at any given age.”

Ovarian reserve refers to women’s potential to get pregnant, depending on the quantity and quality of the eggs in the ovaries.

With ageing, the eggs keep deteriorating in function and number, ending with menopause. But in the case of ovarian ageing, the process gets accelerated.

Dr Dhorepatil cites an example of her 17-year-old patient, a college student from Mumbai who visited the clinic complaining of irregular periods: “On evaluation, her ovaries were 1.5 cm and very small. By the time she is 22, according to her age, her number of ovaries will reduce. She will have to plan her married life with pregnancy accordingly.”

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How do ovaries age?

It is a rather complex process. The ovaries are made up of thousands of follicles — small, fluid-filled sacs that contain one immature egg. Since birth, a large number of follicles break down.

Although women are born with millions of them, eventually she will ovulate — release the egg from the follicles — only about 400-500 times in her entire life.

This means that 99% of our ovarian follicles are wasted. Our fertility decreases gradually with age. But after 35, the decline is more rapid until menopause at around age 51.

But when these follicles rapidly deteriorate, we have what is called premature ovarian ageing. And that’s bad news any way you look at it.

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What are the symptoms of premature ovarian ageing?

How do you know whether your ovaries are sprinting ahead of you in terms of ageing? Dr Dhorepatil says, “If your ovaries fail to function properly and there are no eggs produced then the expert will have to predict this.”

She says that the symptoms will be like those of menopause.  Those are:

• Early-onset of osteoporosis, bone loss, back and knee pain
• Heart and liver problems
• Diabetes
•  Sexual dysfunction

As a result of some of these symptoms, Dr Dhorepatil says that some women experience low self-esteem and even depression. “To top it all, you may feel older and there will be a loss of fertility,” she adds.

As of 2019, more than 15% of couples in the world are battling infertility in their childbearing years.

Why is this bad news?

When ovaries age, they reduce their oestrogen secretion. And as we all know, we ladies need our oestrogen.

Lesser oestrogen in the body means an increased risk of heart disease, osteoporosis, cancer, obesity, dementia, and others.

Hence, ovarian ageing is the pacemaker of the female body ageing. Once the ovaries start ageing, all the other organs follow suit.

What causes ovarian ageing?

While we don’t know what causes ovarian ageing, it can be genetic, according to Dr Dhorepatil. “If the mother gets early menopause, the daughter may get it early as well.”

Other causes include:

• Hypothyroidism
• X chromosome abnormality
• Ethnicity — women of Southeast Asian origin go through early menopause
• Women on chemotherapy or radiation
• Smoking

How do you treat it?

Dr Dhorepatil says that treatment should be time-bound. Women encountering the problem should go for early pregnancy.

“Premature ovarian insufficiency and failure is a growing concern in the general population. Lifestyle modifications in general like no smoking will help. In 35-40 years of family planning, ask the doctor about how much time you have and opt for a blood test like AMH, in case of scanty menses,” she adds.

What else can work?

Vitamin C and E are antioxidants that can work against or prevent ovarian ageing. Have a diet rich in vitamin C with foods like limes, lemons, gooseberries, strawberries, kiwi, mango, and vegetables such as broccoli, tomatoes, and peppers.

For vitamin E, the richest dietary sources are nuts, spinach, whole grains, olive oil, and sunflower oil.

Good old turmeric and its active ingredient curcumin are great for ovarian tissue health.

Foods like blueberries, grape seeds, black and red grapes, strawberries, cranberries, red wine, apples and chocolate contain something called Proanthocyanidins, which protects tissues from oxidative damage. So include a good measure of these ingredients in your diet.

Plant polyphenols like quercetin found in apples, honey, raspberries, onions, red grapes, cherries, citrus fruits, and green leafy vegetables can also protect your ovarian reserve.

What may also work is caloric restriction, according to a study. It says limiting your caloric intake to 25% to 50% of your normal diet can postpone bodily ageing. But caloric restriction can be difficult to follow if you already have a hectic lifestyle.

Here’s a recipe for good hormonal health I found in a very helpful website. I may have tweaked the original recipe.

It’s a smoothie (so to speak) made from beets, turmeric, ginger, gooseberry, carrots, apples and cucumber, which I have been religiously glugging down for the past week. Too soon to say whether it has started showing any big results. But I will update you on that in the coming weeks.