Abstract

Premature Ovarian Insufficiency (POI) is characterized by loss or marked disturbance of ovarian activity before 40 years of age. It may present with irregular or absent menstruation, hypoestrogenic symptoms, infertility, and increased long-term risks affecting bone, cardiovascular, sexual, and psychological health. Ovarian activity can be intermittent, which makes the condition biologically different from completed natural menopause. Contemporary research links POI and ovarian ageing with accelerated follicular depletion, genetic susceptibility, autoimmunity, iatrogenic injury, oxidative stress, mitochondrial dysfunction, genomic damage, inflammation, and changes in the ovarian microenvironment. Ayurveda describes declining reproductive capacity through Beeja Kshaya, Artava Kshaya, progressive Dhatukshaya, age-related Vata predominance, and reduced tissue resilience. Rasayana offers a preventive and restorative framework directed toward tissue nourishment, healthy ageing, and physiological adaptability. Experimental studies of selected Rasayana plants report antioxidant, antiinflammatory, immunomodulatory, and cytoprotective effects, but clinical evidence for preservation or restoration of ovarian reserve remains limited. This review compares the two knowledge systems without treating their terms as biological synonyms. The most responsible integrative approach combines timely diagnosis, hormone and fertility counselling, long-term risk management, lifestyle support, and carefully standardized Ayurvedic adjuncts. Future studies should use reproducible Ayurvedic assessment, validated ovarian reserve measures, authenticated interventions, safety monitoring, and clinically meaningful outcomes.