Menopausal symptoms in breast cancer survivors nearly 6 years after diagnosis

Davis, Susan Ruth; Panjari, Mary; Robinson, Penelope Jane; Fradkin, Pamela; Bell, Robin Jean

doi:10.1097/gme.0000000000000219

Cited by 49 publications

(40 citation statements)

References 20 publications

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“…In a study of childhood and young adult cancer, the chemotherapy regimens most associated with early non‐surgical menopause included alkylating agents, possibly related to cyclophosphamide dose 6 . The severity of vasomotor symptoms does not appear to differ among patients with cancer by chemotherapy history, although dyspareunia may be worse after chemotherapy 7 , 19 …”

Section: Mechanisms Of Cancer‐related Menopausementioning

confidence: 99%

“…6 The severity of vasomotor symptoms does not appear to differ among patients with cancer by chemotherapy history, although dyspareunia may be worse after chemotherapy. 7,19 Endocrine therapy-induced menopausal symptoms…”

Section: Chemotherapy-induced Menopausementioning

confidence: 99%

“…This may contribute to patient distress. Moreover, for many breast cancer survivors, menopausal symptoms are among the most persistent and bothersome effects of treatment and may be more common and severe than in other women 7 , 8 …”

mentioning

confidence: 99%

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Managing menopausal symptoms after cancer: an evidence‐based approach for primary care

Marino

McNamara

Hickey

2018

Medical Journal of Australia

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Summary Impaired ovarian function and menopausal symptoms are common after cancer treatment. Menopausal symptoms often occur at an earlier age in women with cancer, and may be more severe than in natural menopause; they may be the most persistent and troubling sequelae of cancer. A third of female patients with cancer report dissatisfaction with the quality and length of physician–patient discussions about reproductive health, including menopause. Systemic menopausal hormone therapy is the most effective treatment for menopausal symptoms, but it is not suitable for all patients after cancer — where it is unsuitable, alternative effective non‐hormonal treatments are available. Effective pharmacological agents available to treat vasomotor symptoms include selective serotonin reuptake inhibitors, serotonin–noradrenaline reuptake inhibitors, clonidine and gabapentin. There is increasing evidence supporting cognitive behavioural therapy for the treatment of vasomotor symptoms, in self‐help or group settings. Vaginal atrophy can be treated with vaginal (topical) oestrogen with minimal systemic absorption; topical vaginal lubricants may help with vaginal dryness and dyspareunia, with some evidence suggesting that silicone‐based products may be more effective than water‐based ones. Bone health may be impaired in post‐menopausal women with cancer or in cancer survivors, particularly in women with treatment‐related menopause or in women receiving anti‐oestrogen therapies; this should be managed in addition to menopausal symptoms. Primary care physicians should be aware of the troublesome and ongoing nature of menopausal symptoms after cancer, should discuss them with all patients after cancer treatment, and should consider treatment or referral to a specialist for appropriate management.

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Section: Mechanisms Of Cancer‐related Menopausementioning

confidence: 99%

Section: Chemotherapy-induced Menopausementioning

confidence: 99%

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Managing menopausal symptoms after cancer: an evidence‐based approach for primary care

Marino

McNamara

Hickey

2018

Medical Journal of Australia

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show abstract

“…Vasomotor symptoms are common in breast cancer patients and may be more severe and persistent than in the general population. 19 Systemic HRT is avoided after breast cancer, and non-hormonal treatments may be needed. Most women experience a resurgence of vasomotor symptoms when HRT is discontinued, 20 which may require treatment with non-hormonal approaches.…”

Section: Who Is Affected?mentioning

confidence: 99%

Non-hormonal treatments for menopausal symptoms

Hickey

Szabo

Hunter

2017

BMJ

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“…3<5 In the study by Davis et al, 2 it seemed that only a subset of women initiated OET, and it was unclear whether ongoing assessments of persistence occurred. Despite the positive benefits of OET, adherence rates are suboptimal.…”

mentioning

confidence: 99%