title: Natural menopause and ovarian toxicity associated with breast cancer therapy.
abstract: OBJECTIVE
  To provide essential knowledge of the physiologic changes and symptoms associated with declining ovarian function as a basis for assessment and intervention of premenopausal women treated for breast cancer.
  
  
  METHODS
  Published articles selected from computerized databases; reference texts and lay publications on women's health and menopause.
  
  
  RESULTS
  In healthy mid-life women, the years preceding and immediately following menopause are characterized by hormonal changes that result in altered menstrual bleeding patterns that progress to cessation of menses. These physiologic changes may be associated with hot flashes; changes in the vaginal epithelium; and mood, cognitive, and sleep alterations that are described as early menopausal symptoms. Adjuvant therapy for breast cancer suppresses ovarian function resulting in a wide variability of menstrual patterns, hormonal changes, and symptom experiences among treated premenopausal women. The natural perimenopausal transition informs our understanding of women who experience chemotherapy-induced premature menopause.
  
  
  CONCLUSIONS
  Knowledge of the underlying physiology and symptom experience of natural and drug-induced menopause provides a foundation for oncology nurses. This foundation is essential to assessment and clinical decision making in the care of women with breast cancer.
authors.affiliation: Yale University School of Nursing, New Haven, CT, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Knobf
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000451:nursing; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D010053:Ovary / Q000187:drug effects* / Q000502:physiology; D017697:Premenopause / Q000187:drug effects* / Q000502:physiology
chemical_list: D000970:Antineoplastic Agents