1. Is reversal really possible?

Emerging research suggests that it could be, at least temporarily. Scientists are looking at two potential treatments, melatonin therapy and ovarian rejuvenation. Each therapy aims to reduce the symptoms of menopause and revive natural ovulation.

Research into these treatments is still in its early stages. Here’s what we know so far and what we still need to find out before these therapies become widely accessible.

Ovarian rejuvenation is a procedure developed by fertility doctors in Greece. During the procedure, doctors inject your ovaries with platelet-rich plasma (PRP). PRP, which is used in other fields of medicine, is a concentrated solution derived from your own blood.

The procedure is based on the natural growth factors in PRP that can aid in:

  • tissue regeneration
  • improving blood flow
  • reducing inflammation

The theory is that it may also reverse signs of aging in your ovaries and activate previously dormant eggs.

To test this, doctors at the Genesis Clinic in Athens conducted a small study with eight women in their 40s. Each of these women had been period-free for about five months. Researchers tested their hormone levels at the beginning of the study and on a monthly basis thereafter to determine how well their ovaries were functioning.

After one to three months, all participants resumed normal periods. Doctors were then able to retrieve mature eggs for fertilization.

For years, researchers have been investigating the connections between menopause and melatonin. Melatonin, the sleep hormone, is produced in your pineal gland. Older research shows that the pineal gland begins to shrink as you approach menopause.

Researchers believe melatonin plays an important role in the production of reproductive hormones. Without it, reproductive hormone levels begin to plummet.

One study found that a nightly dose of 3 milligrams of melatonin restored menstruation in participants ages 43 to 49. These participants were either in perimenopause or menopause. No effects were seen in participants ages 50 to 62.

Although more research is required, melatonin could be a natural and safe way of delaying, or potentially reversing, menopause.

Getting pregnant during perimenopause can be challenging, but not impossible. A procedure like ovarian rejuvenation may help trigger your ovaries to begin releasing eggs again.

During ovulation, mature follicles in your ovaries burst and release an egg or eggs. Once perimenopause has begun, ovulation becomes less consistent and you don’t release a viable egg every month. The important thing is that your ovaries still hold viable eggs.

The ovarian rejuvenation procedure may help restore or rebalance the reproductive hormones responsible for maturing and bursting follicles. This will allow you to become pregnant naturally or allow doctors to retrieve an egg for in vitro fertilization (IVF).

In the only peer-reviewed study conducted so far, researchers found that all four participants produced an egg capable of being extracted for fertilization.

An international team of clinical researchers — including the Greek doctors who pioneered ovarian rejuvenation and a team of California doctors — have been conducting early-stage clinical trials since 2015.

Their unpublished data claims that, of the more than 60 women in menopause (ages 45 to 64) who have undergone the procedure:

  • more than 75 percent now have the option of pregnancy, most likely through IVF
  • more than 75 percent have seen their hormone levels return to youthful levels
  • nine have become pregnant
  • two have had live births

This data is very preliminary and large-scale placebo-controlled trials are required before making any conclusions about the treatment’s efficacy.

Clinical trials have found a nightly dose of melatonin may reduce feelings of depression and improve overall mood for women in menopause. This treatment may be suited for someone looking to minimize menopause symptoms rather than restore fertility.

Melatonin may also have protective effects for older women against some cancers — including breast cancer — and certain metabolic disorders. It’s also been shown to improve the immune system.

Although data on the longevity of these treatments is extremely limited, it’s pretty clear that the effects aren’t permanent. Inovium, the international team running early-stage clinical trials on ovarian rejuvenation, vaguely says that their treatment lasts, “for the full duration of a pregnancy and beyond.”

Melatonin therapy has proven to be effective against a number of age-related conditions in women who are postmenopausal. Although it won’t keep you fertile forever, it may serve as a long-term protective factor against some age-related health conditions.

There isn’t enough data available to know how long the effects of ovarian rejuvenation will last.

Doctors at the Inovium group mention a few cases of older women coming back for a second treatment. This suggests that the ovarian rejuvenation procedure can only temporarily prevent symptoms. Once the treatment stops working, symptoms will probably return.

Melatonin may help reduce the symptoms of menopause during your transition. There’s no data suggesting that symptoms come rushing back once you stop taking the supplements.

Ovarian rejuvenation treatment involves injecting PRP into your ovaries. Although PRP is made from your own blood, it may still have risks associated with it. Most of the data on PRP injections show that it’s safe to use, but the studies have been small and limited. The long-term effects haven’t been evaluated.

Some researchers question whether injecting PRP into a localized area could have cancer-promoting effects.

According to the National Institutes of Health, melatonin supplements appear to be safe for short-term use, but there isn’t enough data to make a determination about long-term use. Because it’s a naturally occurring hormone, most people tolerate melatonin well.

When side effects do occur, they may include:

  • dizziness
  • drowsiness
  • headache
  • nausea

The unpublished data from the Inovium team documents their experience treating 27 women experiencing menopause. The results of these ovarian rejuvenation procedures are less promising than earlier data sited on their website.

Although 40 percent — or 11 out of 27 participants — began menstruating again, only two produced a healthy egg for extraction. And only one became pregnant.

Pregnancy becomes more difficult with age. In women of advanced age, pregnancies are more easily lost due to chromosomal abnormalities in the fetus.

Women over the age of 40 are also more likely to experience pregnancy complications, such as:

Most people are eligible to begin melatonin treatment. Melatonin is available without a prescription, though it’s always a good idea to discuss new supplements with a doctor.

Ovarian rejuvenation is now available at several fertility clinics around the United States. Most people in good health with working ovaries are eligible for this elective procedure. But costs can be steep, and it isn’t covered by insurance.

Clinical trials can sometimes allow for more affordable treatment. Unfortunately, clinical trials aren’t always taking place, and when they are, they may only recruit a small number of patients. Trials also have specific recruitment criteria, such as being over 35 or the ability to receive IVF treatments at an out-of-town clinic.

When combined with IVF, which is recommended when trying to get pregnant after ovarian rejuvenation, out-of-pocket costs are high.

The cost of ovarian rejuvenation alone is around $5,000 to $8,000. You’ll also need to factor in travel. One cycle of IVF may add another $25,000 to $30,000 to the bill.

Ovarian rejuvenation is considered an experimental treatment, so most insurance companies won’t cover it. If your insurance company covers IVF, that may help reduce cost.

If you have symptoms of menopause or you’re wondering whether it’s still possible to become pregnant, talk with your doctor. You may decide to go the natural route with melatonin or hormone replacement therapy in place of ovarian rejuvenation.