title: Menopausal symptoms in women undergoing chemotherapy-induced and natural menopause: a prospective controlled study.
abstract: BACKGROUND
  Women with breast cancer frequently undergo menopause following adjuvant chemotherapy. Here, we investigated whether they have more severe symptoms than women undergoing natural menopause.
  
  
  METHODS
  Forty-one women who had undergone menopause as a result of chemotherapy and 57 healthy women who had undergone recent natural menopause were evaluated on two occasions 1 year apart. The primary end point was the summed score of the self-report Functional Assessment of Cancer Therapy, endocrine symptoms (FACT-ES) scale. Quality of life was evaluated by the FACT-G questionnaire and fatigue by the FACT-F subscale.
  
  
  RESULTS
  There was a strong trend for patients to report worse FACT-ES scores than controls at the first (P = 0.05) and second (P = 0.04) time points. More patients had moderate/severe hot flashes than controls undergoing natural menopause (51% versus 19%, P = 0.003). Patients reported worse fatigue than controls at the first assessment (P = 0.04), with no difference at the second. Menopausal symptoms were associated with fatigue for both groups. There was no difference between patients and controls in the quality-of-life scale, although assessment of patients is likely subject to adaptation and response-shift bias.
  
  
  CONCLUSIONS
  Women undergoing chemotherapy-induced menopause may experience worse symptoms than women undergoing natural menopause.
authors.affiliation: Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada.
authors.forename: H G
authors.initials: HG
authors.lastname: Mar Fan
authors.forename: N
authors.initials: N
authors.lastname: Houédé-Tchen
authors.forename: I
authors.initials: I
authors.lastname: Chemerynsky
authors.forename: Q-L
authors.initials: QL
authors.lastname: Yi
authors.forename: W
authors.initials: W
authors.lastname: Xu
authors.forename: B
authors.initials: B
authors.lastname: Harvey
authors.forename: I F
authors.initials: IF
authors.lastname: Tannock
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D019584:Hot Flashes / Q000139:chemically induced; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome