Anti‐Müllerian hormone in premenopausal women following treatment of uterine cervical cancer

Everhov, Åsa H; Bergmark, Karin; Smedby, Karin E.; Hirschberg, Angelica Lindén; Rådestad, Angelique Flöter

doi:10.1111/aogs.12448

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…The undetectable AMH levels seen after RT indicate a permanent loss of fertility in premenopausal women. This is consistent with earlier studies reporting on women treated for gynaecological malignancies, and expected biologically as RT with a dose of less than 2 Gy leads to cell death in half of oocytes. Younger women should be offered the possibility of discussing fertility before starting treatment.…”

Section: Discussionsupporting

confidence: 90%

Effect of radiotherapy for rectal cancer on female sexual function: a prospective cohort study

Röjvall¹,

Buchli

Bottai³

et al. 2020

Journal of British Surgery

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Background Clinical experience and limited data show that female sexual function is influenced negatively by preoperative radiotherapy (RT) for rectal cancer. The aim of this prospective study was to investigate the impact of RT on sexual function and ovarian reserve measured by levels of anti‐Müllerian hormone (AMH). Methods Women with stage I–III rectal cancer scheduled for surgery with or without preoperative (chemo)RT were included and followed for 2 years. Female Sexual Function Index (FSFI) questionnaire responses and blood samples for hormone analyses, including AMH in women aged 45 years or less, were collected at baseline and during follow‐up. Results In the group of 109 women who received preoperative RT, median scores in all FSFI domains decreased over time, as did the total FSFI score (from 18·5 (range 2·0–36·0) at baseline to 10·8 (2·0–34·8) at 2 years; P < 0·001). In the group of 30 women who did not receive preoperative RT, only satisfaction declined over time (from 3·2 (0·8–6·0) to 1·8 (0·8–6·0); P = 0·012). In longitudinal regression analysis, the mean decline in FSFI total score was –9·33 (95 per cent c.i. –16·66 to –1·99; P = 0·013) for women who had preoperative RT compared with those who did not, with adjustment for age, Psychological General Well‐being Index score and relationship with partner. A corresponding association was seen for arousal, lubrication, orgasm and pain. Five of six women aged 45 years or less with detectable serum levels of AMH at baseline had undetectable levels after RT. Conclusion Preoperative RT was associated with impairment in sexual function in women with rectal cancer. This needs to be considered when discussing choice of treatment and rehabilitation. In younger women, undetectable AMH levels after RT indicate an irreversible loss of ovarian follicles.

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Section: Discussionsupporting

confidence: 90%

Effect of radiotherapy for rectal cancer on female sexual function: a prospective cohort study

Röjvall¹,

Buchli

Bottai³

et al. 2020

Journal of British Surgery

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“…Even premenopausal patients who undergo ovarian conservation will suffer impairment of ovarian function after hysterectomy through damage to ovarian blood supply [11].…”

Section: Cervical Cancermentioning

confidence: 99%

Sexual and Psychosexual Consequences of Treatment for Gynaecological Cancers

2021

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Sexual, bladder, bowel and ovarian function 1 year after robot‐assisted radical hysterectomy for early‐stage cervical cancer

Wallin

Falconer

Rådestad

2019

Acta Obstet Gynecol Scand

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Introduction Surgery by open radical hysterectomy for cervical cancer is associated with sexual dysfunction as well as lymphedema and bladder problems. Our aim was to assess the impact of robot‐assisted laparoscopic radical hysterectomy (RRH) with pelvic lymphadenectomy for early‐stage cervical cancer on sexual, bowel, bladder, and lymphatic function and to measure ovarian function after RRH. Material and methods Twenty‐six women with early‐stage cervical cancer during 2011‐2013 were investigated before and 1 year after RRH using a validated questionnaire measuring psychological well‐being and sexual, bowel, bladder, and lymphatic function. Blood samples for follicle‐stimulating hormone (FSH), luteinizing hormone (LH), sex‐hormone‐binding globulin (SHBG), estradiol, total testosterone, androstenedione, and anti‐Müllerian hormone (AMH) were analyzed at baseline and 1 year after treatment. Results Anxiety and depression increased in 17/26 (62%) and 16/26 (65%) of the women respectively. Sexual distress symptoms reported 1 year after RRH were numbness of the labia (P = 0.04) and deep pain during intercourse (P = 0.02). Twelve of 26 (46%) had lymphedema, and 10/26 (35%) had bladder problems 1 year after surgery. Levels of FSH and LH were significantly increased (P < 0.01) and AMH decreased (P = 0.02) 1 year after RRH in women <45 years with preserved ovaries. Androgen levels were unchanged. Conclusions In our study, RRH was associated with minor sexual dysfunction. RRH may facilitate the preservation of posterior branches from the hypogastric nerve that are important for arousal and orgasm. Bladder problems and lymphedema remain the most frequently reported sequelae. Women with preserved ovaries after RRH may have an early onset of menopause.

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Anti‐Müllerian hormone in premenopausal women following treatment of uterine cervical cancer

Cited by 6 publications

References 12 publications

Effect of radiotherapy for rectal cancer on female sexual function: a prospective cohort study

Effect of radiotherapy for rectal cancer on female sexual function: a prospective cohort study

Sexual and Psychosexual Consequences of Treatment for Gynaecological Cancers

Sexual, bladder, bowel and ovarian function 1 year after robot‐assisted radical hysterectomy for early‐stage cervical cancer

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