Relationship of menopausal symptoms and ovarian reserve in reproductive-aged cancer survivors

J Cancer Surviv. 2020 Oct;14(5):607-613. doi: 10.1007/s11764-020-00857-z. Epub 2020 Apr 22.

Abstract

Purpose: This study sought to evaluate the prevalence of menopausal symptoms in a population of reproductive-aged women remote from cancer therapy compared with a group of healthy similar-aged controls and with a cohort of late reproductive-aged (LR) controls.

Methods: Participants were assessed for symptoms of menopause, early follicular phase hormones, and ultrasound examinations. Menopausal symptoms were analyzed in exposed participants and controls using χ2 analyses, Wilcoxon-Mann Whitney tests, and multivariable logistic regression models.

Results: One hundred seventy cancer survivors, 135 similar-aged controls, and 71 LR controls were followed prospectively for an average of 38 months. Compared with similar-aged controls, a greater proportion of survivors reported vasomotor symptoms at some point over the study period (35% vs 19%, p < 0.01), and this proportion was similar to LR controls (44%, p = 0.22). Survivors were more likely to be bothered by vaginal dryness (27%) than similar-aged controls (16%, p = 0.02) or LR controls (14%, p = 0.02). FSH levels were 38.4% higher in those with vasomotor symptoms compared with those without symptoms (p = 0.021).

Conclusions: Reproductive-aged cancer survivors have a higher prevalence of vasomotor symptoms and vaginal dryness than their similar-aged peers.

Implications for cancer survivors: Providers should be attuned to the high prevalence of menopausal symptoms in cancer survivors.

Keywords: Anti-Mullerian hormone; Antral follicle count; Menopause; Vaginal dryness; Vasomotor symptoms.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-Mullerian Hormone / blood
  • Cancer Survivors / statistics & numerical data*
  • Case-Control Studies
  • Chemoradiotherapy
  • Female
  • Humans
  • Menopause / drug effects
  • Menopause / physiology*
  • Menopause / radiation effects
  • Middle Aged
  • Neoplasms / physiopathology*
  • Neoplasms / therapy
  • Ovarian Reserve / drug effects
  • Ovarian Reserve / physiology*
  • Ovarian Reserve / radiation effects
  • Prognosis
  • Prospective Studies
  • Reproduction*
  • Survival Rate
  • Ultrasonography
  • Young Adult

Substances

  • Anti-Mullerian Hormone