Study of Menstrual Irregularities in Premenopausal Women Receiving Chemotherapy for Cancer

Abstract

The effect of chemotherapy on the menstrual cycle changes of patients who have undergone cancer treatment, mainly for breast cancer, was studied. For comparison, patients with nasopharyngeal, leukemia, buccal mucosa, and tongue cancers were also included in the study. The average age of the patients was 38. For breast cancer patients, the treatment was mostly a combination of doxorubicin, cyclophosphamide, and docetaxel or paclitaxel. Trastuzumab was also used in combination with other drugs for some patients. Appropriate treatments were given to patients with other cancers. This preliminary study was done with a group of 25 patients. Amenorrhea (stoppage of menses) was observed for about 75% of patients. For those patients for whom menses was restarted, it occurred after 1, 4, or 12 months after complete cessation of chemotherapy. No clear differentiation was observed for breast cancer vs. other cancer patients in the stoppage or restarting of menses with chemotherapy. Induction of amenorrhea after the chemotherapeutic intervention can be considered as a clear indication that the drugs are working as expected. Since the observation was made in patients of child-bearing age, the information could be used for counseling similar patients about the possibility of infertility and teratogenicity associated with chemotherapy. This preliminary study shows that the changes in menstrual characteristics upon chemotherapy in South Indian women are like those reported for the Western population. Induction of amenorrhea and resumption of menses after termination of the chemotherapy, the key parameters evaluated in this study, showed similar trends in both populations.