Management of Early Menopause Using Traditional Persian Medicine: A Case Report

During the past few decades, the rate of fertility has dramatically reduced in all the countries worldwide. However, the magnitude of such a decline varies in various countries (1). Early menopause and abnormal early infertility can affect self-efficacy and self-esteem (2). Premature ovarian failure (POF) is the disruption of the activity of ovaries before the age of forty. This appears when ovaries lose their follicular and hormonal functions. In fact, a decrease in the number of ovaries follicles before the age of menopause is considered physiologic (3). According to the definition of the World Health Organization (WHO), menopause is defined as stoppage of menstruation bleeding due to deactivation of ovarian follicles accompanied by twelve months of bleeding stoppage or amenorrhea during the age of 45-55 (4). It seems that POF occurs when the follicles number is decreased by autoimmune damage accompanied by genetic predisposing factors. This happens in 1% of the women younger than 40 years and 0.1% before the age of thirty (5). Based on the results of the studies performed in Iran, the age range of menopause is 46 to 52 years (6). This phenomenon affects women’ health status and quality of life by hormonal changes (7). It is thought that chronic diseases including cardiovascular disorders and several malignancies like endometrium and breast cancers are due to the activity of ovary function (8). In addition, premature menopause can increase the risk of cardiovascular diseases and bone loss (9). Menopausal symptoms were highlighted as bone disease, hot flash, parasomnia, anxiety, skin shrinkage, and irritability and different studies represented an association between these symptoms and the age of menopause (10). Therefore, menopause is of great importance due to its effects on health status. Hormone replacement therapy (HRT) is an acceptable treatment for POF of the patients, which maintains the natural cycle. However, it has its own side effects such that some physicians and patients prefer complementary and alternative medicine (2). Several studies were conducted regarding using alternative therapies in the treatment of different developer factors of infertility (11-14). In traditional Persian medicine, all creatures are composed of 4 elements of water, fire, air, and soil which include the four temperament theories Abstract Interruption of the activity of ovary before the age of forty is called premature ovarian failure (POF) in which ovaries lose their follicular and hormonal functions. A decline in the number of ovules before the age of menopause is a physiologic phenomenon. In the present case report, treatment of a patient by POF was reported using traditional Persian medicine principles. In Persian medicine, each humor has its own temperament. A change in the temperament and quality or quantity of these humors causes the disease and therefore modifying the temperament is the milestone of treatment. The patient was a 39-year-old married woman with irregular menstruation cycles and finally, cessation of menstruation. In this period, the patient had vaginal dryness, severe dyspareunia, gastritis, and parasomnia. At first, some instructions were ordered to change her lifestyle, for example, a change in food intakes, enough sleep, and exercise. In addition, several medications were ordered including the digestive system electuary (Majoun Jahaz Hazemeh), Eyaraj Fighara capsule and powder containing Glycyrrhiza glabra roots, Foeniculum vulgare and white sugar, oil massage of the abdomen and flanks, and cupping of the uterus. At the end of treatment, complete rehabilitation was achieved and menstruation irregularity, gastritis, and parasomnia were resolved. Based on the results, if a patient follows the rules and has a healthy lifestyle, inappropriate humor is unable to appear, the healing can be stable, and this disease or similar melancholic disorders fail to occur.