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. 1989 Dec 16;299(6714):1494–1497. doi: 10.1136/bmj.299.6714.1494

Consequences and treatment of ovarian failure after total body irradiation for leukaemia.

M P Cust 1, M I Whitehead 1, R Powles 1, M Hunter 1, S Milliken 1
PMCID: PMC1838360  PMID: 2514860

Abstract

OBJECTIVE--To assess the incidence and severity of physical and psychosexual symptoms in young women due to ovarian failure caused by total body irradiation for leukaemia and the women's response to hormone treatment. DESIGN--Postal questionnaire and interview. SETTING--Leukaemia unit of oncology hospital. PATIENTS--Consecutive series of 46 English speaking women who had developed ovarian failure after total body irradiation and bone marrow transplantation as treatment for leukaemia. RESULTS--Of the 36 responders, 33 reported some symptoms, vaginal dryness being the most common (29). This profoundly affected sexual function. Although 22 women had had sexual intercourse within six months after treatment, 16 were less interested in and 18 experienced difficulties with sexual intercourse. Anxieties about sterility, femininity, and appearance were common and reduced self confidence. Almost half reported that they had changed their social habits and restricted their social activities. Treatment seemed effective in abolishing symptoms in 24 women, but vaginal dryness remained a problem in three. Two women failed to respond and intercourse remained impossible. CONCLUSIONS--Such patients are vulnerable and access to gynaecologists and endocrinologists soon after treatment would be valuable. The optimal treatment regimen and the long term benefits of treatment have yet to be established.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aiman J., Smentek C. Premature ovarian failure. Obstet Gynecol. 1985 Jul;66(1):9–14. [PubMed] [Google Scholar]
  2. Alper M. M., Garner P. R., Seibel M. M. Premature ovarian failure. Current concepts. J Reprod Med. 1986 Aug;31(8):699–708. [PubMed] [Google Scholar]
  3. Board J. A., Redwine F. O., Moncure C. W., Frable W. J., Taylor J. R. Identification of differing etiologies of clinically diagnosed premature menopause. Am J Obstet Gynecol. 1979 Aug 15;134(8):936–944. doi: 10.1016/0002-9378(79)90869-x. [DOI] [PubMed] [Google Scholar]
  4. Christiansen C., Christensen M. S., McNair P., Hagen C., Stocklund K. E., Transbøl I. Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females. Eur J Clin Invest. 1980 Aug;10(4):273–279. doi: 10.1111/j.1365-2362.1980.tb00033.x. [DOI] [PubMed] [Google Scholar]
  5. Clift R. A., Buckner C. D., Thomas E. D., Kopecky K. J., Appelbaum F. R., Tallman M., Storb R., Sanders J., Sullivan K., Banaji M. The treatment of acute non-lymphoblastic leukemia by allogeneic marrow transplantation. Bone Marrow Transplant. 1987 Oct;2(3):243–258. [PubMed] [Google Scholar]
  6. Colditz G. A., Willett W. C., Stampfer M. J., Rosner B., Speizer F. E., Hennekens C. H. Menopause and the risk of coronary heart disease in women. N Engl J Med. 1987 Apr 30;316(18):1105–1110. doi: 10.1056/NEJM198704303161801. [DOI] [PubMed] [Google Scholar]
  7. Doney K., Buckner C. D., Kopecky K. J., Sanders J. E., Appelbaum F. R., Clift R., Sullivan K., Witherspoon R., Storb R., Thomas E. D. Marrow transplantation for patients with acute lymphoblastic leukemia in first marrow remission. Bone Marrow Transplant. 1987 Dec;2(4):355–363. [PubMed] [Google Scholar]
  8. Farish E., Fletcher C. D., Hart D. M., Teo H. T., Alazzawi F., Howie C. The effects of conjugated equine oestrogens with and without a cyclical progestogen on lipoproteins, and HDL subfractions in postmenopausal women. Acta Endocrinol (Copenh) 1986 Sep;113(1):123–127. doi: 10.1530/acta.0.1130123. [DOI] [PubMed] [Google Scholar]
  9. Gale R. P., Champlin R. E. Bone marrow transplantation in acute leukaemia. Clin Haematol. 1986 Aug;15(3):851–872. [PubMed] [Google Scholar]
  10. Helenglass G., Powles R. L., McElwain T. J., Lakhani A., Milan S., Gore M., Nandi A., Zuiable A., Perren T., Forgeson G. Melphalan and total body irradiation (TBI) versus cyclophosphamide and TBI as conditioning for allogeneic matched sibling bone marrow transplants for acute myeloblastic leukaemia in first remission. Bone Marrow Transplant. 1988 Jan;3(1):21–29. [PubMed] [Google Scholar]
  11. KEETTEL W. C., BRADBURY J. T. PREMATURE OVARIAN FAILURE, PERMANENT AND TEMPORARY. Am J Obstet Gynecol. 1964 May 1;89:83–96. doi: 10.1016/s0002-9378(16)35045-1. [DOI] [PubMed] [Google Scholar]
  12. Lindsay R., Hart D. M., Aitken J. M., MacDonald E. B., Anderson J. B., Clarke A. C. Long-term prevention of postmenopausal osteoporosis by oestrogen. Evidence for an increased bone mass after delayed onset of oestrogen treatment. Lancet. 1976 May 15;1(7968):1038–1041. doi: 10.1016/s0140-6736(76)92217-0. [DOI] [PubMed] [Google Scholar]
  13. Lipson A., Stoy D. B., LaRosa J. C., Muesing R. A., Cleary P. A., Miller V. T., Gilbert P. R., Stadel B. Progestins and oral contraceptive-induced lipoprotein changes: a prospective study. Contraception. 1986 Aug;34(2):121–134. doi: 10.1016/0010-7824(86)90065-x. [DOI] [PubMed] [Google Scholar]
  14. Rebar R. W., Erickson G. F., Yen S. S. Idiopathic premature ovarian failure: clinical and endocrine characteristics. Fertil Steril. 1982 Jan;37(1):35–41. [PubMed] [Google Scholar]
  15. Richelson L. S., Wahner H. W., Melton L. J., 3rd, Riggs B. L. Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med. 1984 Nov 15;311(20):1273–1275. doi: 10.1056/NEJM198411153112002. [DOI] [PubMed] [Google Scholar]
  16. Russell P., Bannatyne P., Shearman R. P., Fraser I. S., Corbett P. Premature hypergonadotropic ovarian failure: clinicopathological study of 19 cases. Int J Gynecol Pathol. 1982;1(2):185–201. doi: 10.1097/00004347-198202000-00006. [DOI] [PubMed] [Google Scholar]
  17. Sullivan K. M., Shulman H. M., Storb R., Weiden P. L., Witherspoon R. P., McDonald G. B., Schubert M. M., Atkinson K., Thomas E. D. Chronic graft-versus-host disease in 52 patients: adverse natural course and successful treatment with combination immunosuppression. Blood. 1981 Feb;57(2):267–276. [PubMed] [Google Scholar]

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