FIGURE 3-3 Estimated probability of amenorrhea among breast cancer survivors, by age at diagnosis and treatment modality.

SOURCE: Reprinted with permission from the American Society of Clinical Oncology. Goodwin PJ, Ennis M, Pritchard KI, Trudeau M, Hood N. 1999b. Risk of menopause during the first year after breast cancer diagnosis. J Clin Oncol 17(8):2365–2370.

The short-term effects of diminished circulating levels of estrogen that occur with menopause include:

  • Hot flashes, sweats, and palpitations (referred to as “vasomotor symptoms”)

  • Vaginal dryness and sexual changes, including pain with sexual intercourse

  • Urinary incontinence

  • Musculoskeletal complaints such as joint pains and skin changes

  • Sleep disturbance

  • Mood changes

Because chemotherapy causes an abrupt change in menopausal status, symptoms can be more severe than those associated with the usual transition that with normal aging lasts from 5 to 10 years (Burstein and Winer, 2000; Ganz, 2001b; Crandall et al., 2004).

Menopausal symptoms are very prevalent among breast cancer survivors, according to the Cancer and Menopause Study, a study designed to

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