Amenorrhea common after Hodgkin’s treatment

Most women stop having their menstrual period, a condition called amenorrhea, after undergoing chemotherapy for advanced-stage Hodgkin’s lymphoma (HL), cancer specialists report in the Journal of Clinical Oncology.

Study author Dr. Karolin Behringer told Reuters Health that doctors need to talk to patients about “late toxicities, especially infertility,” of chemotherapy and radiation therapy before treatment is initiated. Late toxicities or complications are side effects from chemotherapy or radiation therapy that occur long after the treatment ends. Among these, infertility for women is a major concern.

“Patients have to be informed precisely about all late toxicities that might appear,” said Behringer who is from University Hospital Cologne in Germany.

Behringer and colleagues investigated possible risk factors associated with amenorrhea in 405 women younger than 40 years old who had undergone HL treatment

Although nearly 90 percent of women had regular menstrual cycles before treatment, the authors report, most women with advanced-stage HL experienced amenorrhea after treatment.

Amenorrhea was more common among women older than 30 years, regardless of disease stage or treatment regimen.

The use of oral contraceptives appeared to protect against chemotherapy-induced amenorrhea. Use of the pill was associated with a lower rate of amenorrhea (10 percent versus 44 percent among women not taking the pill), the researchers note. Moreover, the highest rates of amenorrhea (around 73 percent) were seen in women treated for advanced-stage HL who did not take the pill during therapy.

The demonstrated potential of oral contraceptives to protect against amenorrhea in women undergoing treatment for cancer deserves further study, researchers conclude.

SOURCE: Journal of Clinical Oncology, October 20, 2005.

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