Ovarian failure following cancer treatment: current management and quality of life
Ovarian failure following cancer treatment: current management and quality of life
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DOI：
10.1093/humrep/den285
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发表时间：
2008-11-01
影响因子：
6.1
通讯作者：
Greenfield, Diana
中科院分区：
文献类型：
--
作者：
Absolom, Kate;Eiser, Christine;Greenfield, Diana
背景技术背景：目前缺乏关于年轻女性接受性腺毒性治疗后早期卵巢功能衰竭的筛查实践和最合适的雌激素替代形式的证据。本研究调查了（i）卵巢功能衰竭的患病率和管理，以及（ii）早期绝经（EM）对生活质量的影响。方法：对288名有性腺毒性治疗史的妇女（年龄18-50岁）进行医疗病例记录审计。从178例（62%）中获得了自我报告的生活质量数据。结果：44%的医学病例记录了卵巢筛查，35%的病例记录了卵巢衰竭。根据自我报告的数据，89/178（50%）的女性报告经历了EM/卵巢衰竭。更年期症状恶化与性活动[快乐（r = 0.29，P < 0.01）、不适（r = 0.50，P < 0.001）和习惯（r = 0.22，P < 0.05）]和总体生活质量（P = 0.01）呈负相关。激素替代疗法是最常用的雌激素制剂;然而，34%的EM/卵巢功能衰竭女性报告未接受任何替代疗法。结论：鉴于绝经期症状的程度和影响，需要进一步的工作来建立筛查卵巢功能的系统，并确定卵巢功能衰竭的适当和有效的管理。
BACKGROUND: There is a lack of evidence regarding current screening practices for incipient ovarian failure in young women following gonadotoxic therapy and the most appropriate form of estrogen replacement. This study examined the (i) prevalence and management of ovarian failure and (ii) quality-of-life implications of early menopause (EM). METHODS: A medical case note audit for 288 women with a history of gonadotoxic therapy (aged 18-50 years) was conducted. Self-reported quality-of-life data were obtained from 178 (62%). RESULTS: Ovarian screening was recorded in 44% of medical case notes, and ovarian failure was documented for 35%. From the self-reported data, 89/178 (50%) women reported experiencing an EM/ovarian failure. Worse menopausal symptoms were negatively associated with both sexual activity [pleasure (r = 0.29, P < 0.01), discomfort (r = 0.50, P < 0.001) and habit (r = 0.22, P < 0.05)] and general quality of life (P = 0.01). Hormone replacement therapy is the most commonly prescribed estrogen preparation; however, 34% of women with EM/ovarian failure reported not taking any replacement therapy. CONCLUSIONS: Given the extent and impact of menopausal symptoms, further work is needed to establish systems for screening ovarian function and to determine appropriate and effective management of ovarian failure.