Menses resumption after cancer treatment-induced amenorrhea occurs early or not at all
Menses resumption after cancer treatment-induced amenorrhea occurs early or not at all
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DOI：
10.1016/j.fertnstert.2015.11.020
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发表时间：
2016-03-01
影响因子：
6.7
通讯作者：
Howards, Penelope P.
中科院分区：
文献类型：
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作者：
Jacobson, Melanie H.;Mertens, Ann C.;Howards, Penelope P.
目的：确定与癌症治疗引起的闭经和月经恢复时间相关的因素。设计：基于人群的队列研究。设置：不适用。患者：年龄在20至35岁之间被诊断患有癌症的女性癌症幸存者，在招募时诊断后至少2年（中位数= 7年;四分位数间距，5-11）。干预：无。主要结果测量：闭经（>= 6个月无月经）和月经恢复。在排除了癌症诊断前接受过直肠切除术的女性后，有1,043名女性有资格进行分析。闭经发生率为31.6%。在接受化疗的女性中（n = 596），诊断时年龄较大（30-35 vs. 20-24岁：校正比值比[aOR] = 2.37; 95%置信区间[CI]，1.30，4.30）和未孕（vs.妊娠：aOR = 1.50; 95% CI，1.02，2.21）是闭经的风险因素。在闭经妇女中，大多数（70.0%）恢复月经，90.0%的妇女在治疗后2年内恢复月经。与淋巴瘤和盆腔癌相比，乳腺癌的幸存者更有可能在超过1年的时间内恢复月经。在年龄较大时诊断的妇女，那些暴露于化疗的妇女，以及那些暴露于任何辐射的妇女经历了更长的月经恢复时间。诊断时年龄较大的妇女更有可能有不规则的周期时，月经returned. Conclusions（S）：治疗引起的闭经是常见的癌症幸存者，虽然大多数妇女在2年内恢复月经。然而，一旦恢复，老年妇女更有可能出现不规则的周期。诊断时的年龄和妊娠史影响闭经的风险。(C)2016年，美国生殖医学会（American Society for Reproductive Medicine）
Objective: To identify factors associated with cancer treatment-induced amenorrhea and time to return of menses.Design: Population-based cohort study.Setting: Not applicable.Patient(s): Female cancer survivors who were diagnosed with cancer between the ages of 20 and 35 and were at least 2 years post-diagnosis at the time of recruitment (median = 7 years; interquartile range, 5-11).Intervention(s): None.Main Outcome Measure(s): Amenorrhea (>= 6 months without menses) and resumption of menses.Result(s): After excluding women with hysterectomies before cancer diagnosis, 1,043 women were eligible for analysis. Amenorrhea occurred in 31.6% of women. Among women treated with chemotherapy (n = 596), older age at diagnosis (30-35 vs. 20-24 years: adjusted odds ratio [aOR] = 2.37; 95% confidence interval [CI], 1.30, 4.30) and nulligravidity (vs. gravid: aOR = 1.50; 95% CI, 1.02, 2.21) were risk factors for amenorrhea. Among amenorrheic women, menses resumed in most (70.0%), and resumption occurred within 2 years of treatment for 90.0% of women. Survivors of breast cancer were more likely to resume menses at times greater than 1 year compared with lymphoma and pelvic-area cancers. Women diagnosed at older ages, those exposed to chemotherapy, and those exposed to any radiation experienced longer times to return of menses. Women who were older at diagnosis were more likely to have irregular cycles when menses returned.Conclusion(s): Treatment-induced amenorrhea is common in cancer survivors, although most women resume menses within 2 years. However, once resumed, older women are more likely to have irregular cycles. Age at diagnosis and pregnancy history affect the risk of amenorrhea. (C) 2016 by American Society for Reproductive Medicine.