Natural menopause and ovarian toxicity associated with breast cancer therapy

To provide essential knowledge of the physiologic changes and symptoms associated with declining ovarian function as a basis for assessment and intervention of premenopausal women treated for breast cancer.

Published articles selected from computerized databases; reference texts and lay publications on women's health and menopause.

In healthy mid-life women, the years preceding and immediately following menopause are characterized by hormonal changes that result in altered menstrual bleeding patterns that progress to cessation of menses. These physiologic changes may be associated with hot flashes; changes in the vaginal epithelium; and mood, cognitive, and sleep alterations that are described as early menopausal symptoms. Adjuvant therapy for breast cancer suppresses ovarian function resulting in a wide variability of menstrual patterns, hormonal changes, and symptom experiences among treated premenopausal women. The natural perimenopausal transition informs our understanding of women who experience chemotherapy-induced premature menopause.

Knowledge of the underlying physiology and symptom experience of natural and drug-induced menopause provides a foundation for oncology nurses. This foundation is essential to assessment and clinical decision making in the care of women with breast cancer.