Can You Delay Ovarian Aging?

Is there anything louder than the sound of your biological clock? Maybe it sounds like a nagging pressure from your mother. Or, increasingly loud footsteps as you walk towards the edge of the so-called fertility “cliff.” Whatever it sounds like to you, if you’ve ever considered starting a family, it’s natural to start wondering about your ovary health and fertility, especially as you get older.

One frustrating fact about the ovaries is that they get older a lot sooner, and a lot faster than the rest of your body does. This means that many people will experience a decline in fertility or health issues related to low estrogen, long before they are ready for it. Researchers have started looking into ways to slow down, or reverse, the aging of the ovaries. But is this really possible? 

What happens to your ovaries as you get older?

As you get older, your ovaries get older, too. And as they age, they stop working as well as they did in the past. 

People go into menopause when their ovaries no longer function. This is the end point of ovarian aging. At this point, the ovaries no longer release mature eggs and you can no longer get pregnant without the help of fertility treatments.

Your age can offer an estimate of your overall ovarian health. But your chronological age isn’t the full story when it comes to fertility and ovarian aging. The number and quality of ovarian follicles in your ovaries is the best measure of your ovarian health.

As ovaries age, they produce fewer and less healthy ovarian follicles. This leads to a decrease in fertility and a drop in estrogen levels.

Follicle quality and quantity decline

Ovarian follicles are fluid-filled sacs that form in your ovaries during your menstrual cycle. Each cycle, a “dominant follicle” develops and releases a mature oocyte (egg) in preparation for fertilization. This process is known as ovulation.

You are born with 1 million to 2 million eggs that live inside “immature follicles” in your ovaries. These are all the eggs your ovaries will ever make and they make up your ovarian reserve. When you start your period (menarche), you lose a certain number of follicles at a fairly consistent rate — about 1,000 follicles each month. But as you get to your mid-thirties, you begin to lose follicles at a faster rate. Once all your follicles are gone, you enter menopause. 

It’s not just the quantity of follicles that changes as you get older. The quality of your follicles also changes. This means that the eggs released during ovulation aren’t as healthy as they used to be. So they are less likely to fertilize and become an embryo. The eggs are also more likely to contain genetic abnormalities, which also lowers the chance of getting and staying pregnant.

EXPERT PICKS: WHAT TO READ NEXT

• Thinking about freezing your eggs? Our experts review the best age to freeze your eggs.

• Can diet affect fertility? Yes, some foods can help keep your ovaries healthy.

• Should you get your fertility tested? Maybe, here’s how to know if you really need fertility testing.

Decreased estrogen

The number and health of your follicles are also really important for estrogen production. Before menopause, your follicles are your body’s main source of estrogen. So, as the quantity and quality of your follicles decrease, so do your estrogen levels.

Estrogen is an important hormone for your fertility and the health of your reproductive organs. Low estrogen levels also make it harder to get and stay pregnant.

Why do ovaries age so fast?

When compared to your other organs, the ovaries are said to start aging a lot sooner, and do so a lot faster. But how fast do they age exactly? It turns out that this speed is hard to put a finger on.

The concept of the “fertility cliff,” which describes a sudden drop in your ability to get pregnant once you hit your mid-thirties, may not be as accurate as once thought. 

Newer research suggests that ovarian aging is a more gradual process that may just speed up a bit around the age of 35. For example, research shows that for those trying to become pregnant naturally:

• There’s an 85% chance of becoming pregnant within a year.

• Once you are 35, your chances drop to 66%.

• At the age of 40, this chance decreases even more, to 44%.

These rates describe a more gradual decline in fertility (not a drop), and it’s still possible to get pregnant when you’re in perimenopause. There are also instances — like with primary ovarian insufficiency — where you can begin to experience menstrual changes and unexplained infertility much sooner than the age of 35 (sometimes even in your teens).

The concept of the fertility cliff may also be too simple of an explanation. While age is one of the biggest factors in ovarian aging, newer research points to a much more individualized process with many additional influencing factors, like:

• Genetics

• Changes in your brain and endocrine system that regulate your menstrual cycle, known as the hypothalamic-pituitary-ovarian (HPO) axis

• Oxidative stress

• Lifestyle factors (like smoking)

What are the symptoms of ovarian aging?

One of the first symptoms of ovarian aging is reduced fertility — difficulties getting or staying pregnant. 

But unless you are actively trying to get pregnant, this is a hard symptom to notice. So in the early stages, there are very few symptoms.

But as the number and quality of your ovarian follicles continue to go down, you’ll start noticing changes in your menstrual cycle. For example, changes in the length of your cycle or skipped periods.

With decreasing levels of estrogen, you may also experience the infamous symptoms of perimenopause (also known as the menopause transition). These include:

• Vasomotor symptoms (like hot flashes and night sweats)

• Sleeping problems

• Mood changes

• Vulvar and vaginal dryness and pain

• Sexual dysfunction (like pain during sex, or changes in libido)

• Urinary dysfunction (like bladder leaks, urgency, and frequency)

• New or worsened pelvic floor dysfunction

• Increased or new joint aches and muscle pain

Can you delay aging of the ovaries?

There’s some evidence to suggest that you can slow down ovarian aging. But ovarian aging is very complex. And there’s still a lot about the process that scientists don’t fully understand. So there’s no single solution. 

Also, most of the research on ovarian aging has been done in animals or in human cells and tissue in a lab setting. So it’s not clear how strategies to delay ovarian aging will work in humans. Right now, scientists are studying the following.

Antioxidants

Some amount of reactive oxygen species (ROS) — also known as free radicals — are thought to be important for follicular growth and egg development. But too much oxidative stress may contribute to ovarian aging. Researchers have examined the use of antioxidants to reduce increasing oxidative stress to slow ovarian aging.

Melatonin, for example, is well known for its ability to regulate your sleep-wake cycle. It’s also a powerful antioxidant. Research in mice shows that long-term melatonin intake slowed ovarian aging by limiting the number of follicles lost each cycle. And when used during assisted reproductive technology (ART) in humans, some research has shown improvements in the number of oocytes and quality of embryos. More high-quality studies are needed to better understand how this may delay ovarian aging in humans who aren’t using ART.

Another antioxidant scientists are studying is metformin. Commonly used to help manage Type 2 diabetes, metformin has anti-inflammatory properties. In rats, researchers found that metformin improved cycle regularity, hormone levels, and ovarian reserve. But there’s no research yet on metformin’s effects on human ovarian aging.

Rapamycin

Rapamycin is an immunosuppressant, commonly prescribed when people receive an organ transplant. It can help regulate cell growth and metabolism. 

Rapamycin was shown to preserve ovarian reserve in rats. And even short-term use was found to improve egg quality and ovarian lifespan in young and middle-aged rats.

A clinical trial is looking at whether rapamycin can help delay ovarian aging in humans. Early results from 34 participants suggest that rapamycin could decrease monthly ovarian follicle loss, and slow ovarian aging by 20%. But these findings are preliminary and based on a small group. As more people are included in the study, these results may change.

How can you keep your ovaries healthy?

Scientists haven’t yet found a way to slow down or stop ovarian aging. But there are steps you can take to keep your ovaries healthy over your lifetime. Keeping your ovaries healthy may help boost your fertility. Some things you can do to keep your ovaries healthy include:

• Move more: Staying active has health benefits for your whole body, including your ovaries. Studies show that regular physical activity can be good for your fertility, especially if you have polycystic ovary syndrome (PCOS).

• Eat a fertility-friendly diet: Research shows that nutrients like folic acid, omega-3 fatty acids, and vitamin B12 may boost female fertility for those trying to become pregnant without ART. Opt for a diet that is rich in fruits, vegetables, whole grains, seafood, and poultry like the Mediterranean diet. 

• Quit smoking: Smoking lowers your fertility. Talk with your primary care provider about options that can help you quit smoking. Smoking cessation can keep your ovaries and your entire body healthy. 

Why trust our experts?

Written by:

Ashley Rawlins, PT, DPT

With over a decade of experience as a physical therapist, Ashley has established herself as a specialist in pelvic health. Her diverse career spans clinical practice, academia, and health content creation.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Adriena Beatty D.O., MBA, CPE

Adriena Beatty, DO, MBA, CPE, is an Army veteran and board-certified obstetrician and gynecologist with over 20 years of experience. She is a graduate from Tuskegee University with a degree in chemical engineering and chemistry.

Our editorial standards

Meet our experts