What happens after menopause? (WHAM): A prospective controlled study of vasomotor symptoms and menopause-related quality of life 12 months after premenopausal risk-reducing salpingo-oophorectomy.

Autor: Hickey M; Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Melbourne, Victoria, Australia. Electronic address: hickeym@unimelb.edu.au., Moss KM; Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Brisbane, Queensland, Australia., Krejany EO; Gynaecology Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia., Wrede CD; Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Melbourne, Victoria, Australia; Gynae-oncology and Dysplasia Unit, The Royal Women's Hospital, Melbourne, Victoria, Australia., Brand A; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia., Kirk J; Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia., Symecko HL; Basser Center for BRCA, University of Pennsylvania, Philadelphia, USA., Domchek SM; Basser Center for BRCA, University of Pennsylvania, Philadelphia, USA., Tejada-Berges T; Gynaecological Oncology Service, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia., Trainer A; Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Mishra GD; Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2021 Oct; Vol. 163 (1), pp. 148-154. Date of Electronic Publication: 2021 Jul 24.
DOI: 10.1016/j.ygyno.2021.07.029
Abstrakt: Objective: To measure menopausal symptoms and quality of life up to 12 months after risk-reducing salpingo-oophorectomy (RRSO) and to measure the effects of hormone therapy.
Methods: Prospective observational study of 95 premenopausal women planning RRSO and a comparison group of 99 who retained their ovaries. Vasomotor symptoms and menopausal-related quality of life (QoL) were measured by the Menopause-Specific QoL Intervention scale at baseline, 3, 6 and 12 months. Chi-square tests measured differences in prevalence of vasomotor symptoms between RRSO vs the comparison group and by hormone therapy use. Change in QoL were examined with multilevel modelling.
Results: Three months after RRSO hot flush prevalence increased from 5.3% to 56.2% and night sweats from 20.2% to 47.2%. Symptoms did not worsen between 3 and 12 months and remained unchanged in the comparison group (p<0.001). After RRSO, 60% commenced hormone therapy. However, 40% of hormone therapy uses continued to experience vasomotor symptoms. After RRSO, 80% of non-hormone therapy users reported vasomotor symptoms. Regardless of hormone therapy use, 86% categorized their vasomotor symptoms as "mild" after RRSO. Following RRSO, Menopause-related QoL deteriorated but was stable in the comparison group (adjusted coefficient = 0.75, 95%CI = 0.55-0.95). After RRSO, QoL was better in hormone therapy users vs non-users (adjusted coefficient = 0.49, 95%CI = 0.20-0.78).
Conclusions: Vasomotor symptoms increase by 3 months after RRSO but do not worsen over the next 12 months. Hormone Therapy reduces but does not resolve vasomotor symptoms and may improve QoL, but not to pre-oophorectomy levels.
Competing Interests: Declaration of Competing Interest MH is an editor for the Cochrane Gynaecology and Fertility Group Editorial Board and has received pharmaceutical funding from QUE Oncology P/L, Madorra P/L and Ovoca Bio (Australia) P/L for clinical research outside of the submitted work. CDW has received sponsorship and honoraria from Biogen and Seqirus and is the Deputy Chair (Honorary) of VCS Foundation P/L. SMD has received personal fees from AstraZeneca outside of the submitted work. KMM, EOK, AB, JK, HLS, TT-B, AT and GDM have no competing interests to declare.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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