How does adjuvant chemotherapy affect menopausal symptoms, sexual function, and quality of life after breast cancer?
The aim of the study was to determine the association between adjuvant chemotherapy for breast cancer and menopausal symptoms, sexual function, and quality of life.



Participants attended a menopause clinic with a dedicated service for cancer survivors at a large tertiary women's hospital. Information about breast cancer treatments including adjuvant chemotherapy was collected from medical records. Menopausal symptoms were recorded with the Greene Climacteric Scale and Functional Assessment of Cancer Therapy, Breast Cancer, and Endocrine Symptom Subscales. Sexual symptoms were recorded using Fallowfield's Sexual Activity Questionnaire. Quality of life was measured with Functional Assessment of Cancer Therapy scales.



The severity of vasomotor, psychological, or sexual symptoms (apart from pain) did not differ between those who had received adjuvant chemotherapy (n = 339) and other breast cancer survivors (n = 465). After adjustment for current age, time since menopause, and current use of antiestrogen endocrine therapy, the risk of "severe pain" with sexual intercourse was twice as common after chemotherapy (31.6% vs 20.0%, odds ratio [OR] 2.18, 95% CI 1.25-3.79). Those treated with chemotherapy were more likely to report "severe problems" with physical well-being (OR 1.92, 95% CI 1.12-3.28) and lower breast cancer-specific quality of life (OR 1.89 95% CI 1.13-3.18), but did not differ in other quality of life measures.



In this large study of breast cancer patients presenting to a specialty menopause clinic, previous chemotherapy was not associated with current vasomotor or psychological symptoms. Severe pain with intercourse was significantly more common in those treated with adjuvant chemotherapy.
1Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia 2School of Surgery, The University of Western Australia, Crawley, Western Australia 3Menopause Symptoms after Cancer Clinic, King Edward Memorial Hospital, Subiaco, Western Australia 4School of Women's and Infants' Health, The University of Western Australia, Crawley, Western Australia, Australia.
Jennifer L
JL
Marino
Christobel M
CM
Saunders
Laura I
LI
Emery
Helena
H
Green
Dorota A
DA
Doherty
Martha
M
Hickey
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D000073116:Cancer Survivors / Q000523:psychology*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D004414:Dyspareunia / Q000139:chemically induced; D005260:Female; D019584:Hot Flashes / Q000503:physiopathology; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D011788:Quality of Life; D012725:Sexual Behavior / Q000187:drug effects*; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced