I posted this on the other forum, but should have posted it here.
Question: Has anyone experienced this while on tx and how were you advised or how did you address this problem on tx or post tx?
I have been reading up a bit about medically induced menopause. As it is induced by chemotherapy for cancer, I was wondering if the same occurs with our HCV treatment. If this really occurs with TX, I feel the need to look into this matter further and discuss some kind of damage control with a physician, concerning hormone therapies, osteoporosis and other factors.
Any input appreciated. Marcia
CHEMOTHERAPY-INDUCED MENOPAUSE: A Clinical Research Study
Chemotherapy-induced menopause was the subject of a clinical research study at the Cancer Center at GBMC and the results were published in Cancer Investigation, 19(6), 641-648 (2001). The study was led by Barbara Poniatowski, MS, RN, C, AORN, clinical nurse specialist and Gary Cohen, MD, Medical Director, Cancer Center, with additional help from Patricia Grimm, MD. A summary of that article follows.
Women who experience menopause before the age of 40 are classified as having premature menopause, which can be induced through ovarian ablation either by surgery, radiation or certain chemotherapeutic agents. A recent published study of 113 premenopausal women treated with adjuvant chemotherapy showed that 38% developed amenorrhea (abnormal absence or suppression of menstruation) during the first year, 36% had irregular menstrual periods and 22% continued regular menses.
If the premature menopause is permanent, the woman will spend as much as one-half of her life in the postmenopausal state (in contrast to one-third of her life with natural menopause). Symptoms produced by premature menopause may be of short or long duration, and can produce physical and psychological distress that impact quality of life.
Premature menopause caused by adjuvant chemotherapy has received scant attention because, historically, breast cancer was a surgical event. Prematurely induced menopause is now of interest because adjuvant chemotherapy with alkylating agents is an accepted and expected part of breast cancer treatment. Most women who are less than 50 years of age will receive adjuvant chemotherapy, which is estimated to reduce recurrence by 30-40% and death by 25%. These women will begin to experience menopausal symptoms 6-12 weeks after therapy. Amenorrhea may be permanent in women who are near the age of natural menopause,with those under age 35 almost always recovering ovarian function.
The chemotherapy-induced premature menopause in younger women may be short-term but could last for months or years. Menopause may place women at an increased risk for both osteoporotic fractures and cardiovascular disease. Because of rapidly declining estrogen levels, the hot flashes, night sweats, vaginal dryness and atrophy caused by chemotherapy-induced menopause may be more severe than the symptoms with natural menopause. As with natural menopause, the vaginal symptoms can lead to difficult or painful intercourse and sexual dysfunction.
The psychological symptoms associated with premature menopause appear to be the same as the symptoms associated with natural menopause. However, women experiencing premature menopause are more concerned about the long-term sequelae than women experiencing natural menopause, due in part to the extended duration of their life in the menopausal state.
Although effective treatments exist to counteract menopausal symptoms, breast cancer patients often fear and avoid estrogen and resort to homeopathic remedies with equivocal results rather than accept estrogen or progesterone creams, estring, megestrol acetate, and other hormone-replacement strategies with proven effectiveness. Randomized controlled trials have also demonstrated symptom relief with the use of certain antidepressants (e.g. paroxetine, venlafaxine, fluoxetine, etc) but some patients refuse those agents because of their association with psychiatric disease. Women suffer in silence and live with unpleasant symptoms for years. Further research is clearly needed to identify risk factors for and safe methods to treat symptoms of premature menopause.