Scientists map risk of premature menopause after cancer treatment

Women treated for the cancer Hodgkin lymphoma will be able to better understand their risks of future infertility after researchers estimated their risk of premature menopause with different treatments.

The findings, set out in the Journal of the National Cancer Institute, are based on the experience of more than 2,000 young women in England and Wales treated for the cancer over a period of more than 40 years.

Previous research has suggested that women with Hodgkin lymphoma who receive certain types of chemotherapy or radiotherapy are at increased risk of going through the menopause early – but there was insufficient information to provide patients with detailed advice.

But the new study, led by scientists at The Institute of Cancer Research, London, provides precise estimates of risk for women depending on which treatment types and doses they received and at what age - allowing doctors to give them detailed advice about their risks of future infertility.

The research was largely funded by Breakthrough Breast Cancer and involved researchers from across the UK at more than 50 universities and hospitals.

The research team followed-up 2,127 women who had been treated for Hodgkin lymphoma in England and Wales between 1960 and 2004, and who had been aged under 36 at the time. All had received treatment with chest radiotherapy, sometimes alongside other treatments.

Some 605 of the women in the study underwent non-surgical menopause before the age of 40. This was a large enough number for the researchers to estimate accurate risks of menopause at different ages, depending on the mixture and doses of treatments they received and the age they received them.

Menopause does not cause cancer, but the risk of developing cancer increases as a woman ages. Therefore, women who have been through natural menopause are more likely to develop cancer because they are older.

About menopause

Menopause occurs when a woman’s ovaries stop releasing eggs. During natural menopause, a woman’s body makes less of the hormones estrogen and progesterone, causing irregular menstrual periods that eventually stop. It generally begins during a woman's mid-40s or early- to mid-50s. However, it may begin earlier if cancer treatment - such as surgery, chemotherapy, or hormone therapy - stops the ovaries from working; this is called premature menopause. Learn more about long-term side effects of cancer treatment.

The symptoms of menopause include hot flashes, night sweats, vaginal dryness, painful sexual intercourse, decreased sex drive, osteoporosis (thinning of the bones), bladder control difficulties, mood swings, and insomnia. Find out how to manage menopausal symptoms.

Menopause and cancer risk

A woman who experiences menopause after age 55 has an increased risk of ovarian, breast, and uterine cancers. The risk is greater if a woman also began menstruating before age 12. This is because a woman who menstruates longer than normal during her lifetime is exposed to more estrogen and has more ovulations. A longer exposure to estrogen increases a woman’s risk of uterine and breast cancers, and having more ovulations than normal increases a woman’s risk of ovarian cancer.