Does a multidisciplinary menopausal symptoms after cancer clinic reduce symptoms?

Jade Hollingworth,Paul A Cohen,Stephanie Tran,Manju Ambekar,Lucy Walsh,Jane Weeks,Lesley Ramage,Shavita Patel-Brown,Lucy Williams

doi:10.1007/s00520-021-06637-4

Abstract

This study aimed to measure the prevalence of menopausal symptoms in patients attending a multidisciplinary model of care clinic at their initial clinic visit and their subsequent follow-up consultation using a validated patient-reported outcome measure to assess whether menopausal symptoms after cancer had improved. A retrospective review was conducted of patients attending the clinic in a 12-month period in 2017 (n = 189). Recorded variables included patient demographics, details of index cancer, previous treatments, and menopausal symptom management strategies. Severity of menopausal symptoms was evaluated using the Greene Climacteric Scale. The extent to which patients were bothered by symptoms was combined into two categories and dichotomized (present/absent). Differences in symptom prevalence between the initial consultation and first follow-up visit were examined using McNemar's test. The majority of patients attending the clinic had a history of breast cancer (72%). Fifty-five percent of patients were prescribed a non-hormonal therapy at their initial visit, most commonly gabapentin. Significantly fewer patients reported being bothered by hot flushes, fatigue, sleep difficulties, and loss of interest in sex, anxiety, or troubles concentrating at the first follow-up visit compared to their initial consultation (p < 0.01). In this study, there was an improvement in self-reported menopausal symptoms in a significant proportion of cancer survivors attending a multidisciplinary menopause clinic between their initial and first subsequent follow-up consultations.

Highlights

Menopause is marked by irregular menstrual cycles, hormonal changes and is often accompanied by vasomotor symptoms, sleep and mood disturbances, and changes in sexual desire and function
The majority of patients attending the clinic had a history of breast cancer (72%). 55% of patients were prescribed a non-hormonal therapy at their initial visit, most commonly gabapentin
Fewer patients reported being bothered by hot flushes, fatigue, sleep difficulties and loss of interest in sex, anxiety or troubles concentrating at the first follow-up visit compared to their initial consultation (p < 0.01)

Summary

Introduction

Menopause is marked by irregular menstrual cycles, hormonal changes and is often accompanied by vasomotor symptoms, sleep and mood disturbances, and changes in sexual desire and function. In Australia, almost a third of women will consult a doctor regarding symptoms of menopause [1]. Not all women are bothered by symptoms of menopause, those with severe symptoms report significant impacts on their quality of life [2]. The symptoms of menopause in patients with a history of cancer are often more severe, owing to the nature and sudden onset of menopause, the need to abruptly cease menopausal hormone therapy (MHT) or the need for ongoing endocrine therapy if indicated. In a study of more than 500 women with a history of breast cancer, more than 60% of survivors had moderate to severe menopausal symptoms affecting both their and their partner’s quality of life. Symptom severity can contribute to poor compliance with prescribed endocrine treatment used to prevent cancer recurrence [4, 5]

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Conclusion