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Related Concept Videos

Menopause01:28

Menopause

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Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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Oogenesis02:07

Oogenesis

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In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
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Hormonal Control of the Ovarian Cycle01:30

Hormonal Control of the Ovarian Cycle

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The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle.  At puberty, GnRH secretion increases in both frequency and...
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Hormonal Regulation of the Menstrual Cycle01:22

Hormonal Regulation of the Menstrual Cycle

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The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
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Ovarian Cycle01:27

Ovarian Cycle

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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
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Disorders of the Female Reproductive System01:24

Disorders of the Female Reproductive System

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The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
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Orthotopic Ovarian Transplantation Procedures to Investigate the Life- and Health-span Influence of Ovarian Senescence in Female Mice
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Ovarian Suppression: Early Menopause, Late Effects.

Chaya Goldberg1, Megan R Greenberg1, Alexandra Noveihed1

  • 1Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Current Oncology Reports
|February 2, 2024
PubMed
Summary

Ovarian function suppression (OFS) helps pre-menopausal women with hormone receptor breast cancer but causes significant toxicities. Managing these side effects is crucial for patient well-being and treatment adherence.

Keywords:
Breast cancerHormone receptor positiveHypoestrogenismOvarian function suppressionPre-menopausal

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Area of Science:

  • Oncology
  • Endocrinology
  • Women's Health

Background:

  • Pre-menopausal women with hormone receptor (HR) breast cancer often require ovarian function suppression (OFS) to reduce estrogen levels and improve outcomes.
  • While OFS offers disease benefits, the associated toxicities are frequently under-reported and can significantly impact quality of life.

Purpose of the Study:

  • To review the toxicities of prolonged ovarian function suppression (OFS) in pre-menopausal women with HR breast cancer.
  • To emphasize the need for balancing the benefits of OFS against its adverse effects and to highlight supportive care strategies.

Main Methods:

  • This review synthesizes existing literature on the toxicities of OFS.
  • It analyzes reported side effects and their impact on patient compliance and long-term health outcomes.

Main Results:

  • OFS is associated with increased risks of cardiovascular, bone, and metabolic disorders.
  • Common toxicities include vasomotor symptoms, urogenital atrophy, weight gain, sexual dysfunction, cognitive decline, and sleep disturbances.
  • These toxicities contribute to poor adherence, particularly in younger patients.

Conclusions:

  • Providers must critically analyze the risks and benefits of OFS when making treatment recommendations.
  • Comprehensive supportive care is essential to manage multi-system toxicities and mitigate long-term impacts on all-cause mortality.
  • Future research should integrate patient-reported outcomes and symptom management strategies alongside disease outcome assessments.