Medically Induced Menopause

[Marcia2202]

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.

[Peachy48]

i was 45 when started tx for hcv and 47 when I finished. I was dx with breast cancer at 49, and my tumor was estrogen and progesteron positive. I had my hormone levels taken and I was no where near menopause, not even. I had a complete hysterectomy and oopherectomy to prevent the estrogen from feeding my breast cancer. So my answer to this is that while its possible, I have asked my doctors this and they say interferon/riba is not usually associated with complete and irreversible menopause.

Peachy

[Marcia2202]

I always so much enjoy your input.

I agree, I used the wrong word. I should have said sensitive instead of fragile. I was referring to the whole hormonal balance etc.

I'm glad it turned out for the best for you.

I remember my late mother had a really hard time and she was still dreading it years later when she talked about it. Menopause had really been a roller coaster for her... me in puberty and her in menopause, can you imagine that combination?  :-))))))) it was not funny for her.

Hugs,

Marcia

[meki]

I wouldn't say fragile - but most definetely something to keep an eye on.

I mean - I don't think every woman went through the same thing --- and each individual is different.

What I experienced - someone else may or may not have the same issue. And what you experience, I may not.

It's all based on your genetics and other health factors that are very individualized.

We all will have that "flu" feeling --- some alopecia - some bone aches as our hemo stats run up and down...

But not all of us will have white blood cell drops to take neupogen...

Not all of us will get depressed and so on...

But yeah - it is another point for women to specifically watch out for... I think it has more to do with the hormonal points than anything else.

And believe it or not - hormones are a very big part in life.

I got to keep one of my ovaries and it appears to be functioning - so I'm doing fairly well. Thank Goodness.

But - I can most definetely tell the difference between pre-hysterectomy -- and post...

And I have to tell you --- right now - I think HAVING the Hysterectomy was probably one of the greatest choices in my life.

I haven't had to worry about messing up clothing - bedding - or missing any trips or ANYTHING.

It's a freedom I never thought I'd experience...

Of course if you had asked me that 3 months ago - I might not be saying the same thing since my pubic bone got broken during the surgery... LOL - but now - heck ya - that's awesome...

I don't think menopause is all that bad anyway. For most of us ladies.

Sometimes it's just plain a pain in the rump...
The sweats - the hormone/emotional roller coaster.

But --- overall - it's not all that bad.

*GRIN*

I have to tell you one thing --- it DOES change your sex life.

For me --- it was for the better.

*SUPER GRIN*

Hugs,

meki

[Marcia2202]

Not too much info.... but plain scary... I'm really sorry to hear that you had to go through that too, on top of all the other things. So you must be having your bone density monitored etc. to prevent osteoporosis. This disease surely complicates a lot of things. Don't we all wish there was another way out!

I guess anything can happen and I just have to be mentally prepared.

Us women are obviously quite fragile in that regard.

Marcia

[Marcia2202]

Thanks for the input

marcia

[meki]

OK - here's probably TOO much information for you.

Interferon and Riba combo (not sure which one) caused me to have super heavy clotting - horrid pains... Or it could have been what caused the Adenymyosis (sp)  --- anyhow - it's the reason I had to have a hysterectomy.

So I am in the middle of menopause "technically".

But - yeah - this stuff messes with your body  - the hormones and stuff.

LMAO --- some of us turn into perverts during that time frame too... LOL!

Meki

[sldb]

I tx'd 96 wks starting age 48, a few months into tx periods stopped and have never returned 4 yrs later....Leah

[Marcia2202]

Thanks for your feed back.

Marcia

[Xenigma]

---I was wondering if the same occurs with our HCV treatment---

I've been reading this board for years and have seen some women
having menstrual cessation while others who thought they
were post-menopausal have it come back while on tx.
With some it's heavier on tx and some lighter.
With some women on tx it is almost ongoing and with others
it lasts a day or 2 per month.
I have been post menopausal for 2 years (at age 48) and remain that way
on tx.  I will be 50 this year.
enigma