Prevalence of menopausal symptoms among young gestational trophoblastic neoplasia survivors and its relationship to their health-related quality of life

BACKGROUND: Since the advent of chemotherapy, cure rates for gestational trophoblastic neoplasia (GTN) have improved significantly. With increased survival, patients must cope with long-term sequelae of their treatment, including early menopause. Unlike natural menopause, treatment-induced menopause may cause a sudden and dramatic decline in estrogen, which can lead to more severe symptoms. OBJECTIVES: This study aimed to evaluate the prevalence of menopausal symptoms among young GTN survivors and to determine the impact of these symptoms on their health-related quality of life (QoL). METHODOLOGY: Ninety GTN survivors (<45 years old) treated from 2012 to 2022 were asked to answer the modified Menopause Rating Scale and the European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 questionnaires. Treatment records were reviewed for the chemotherapy regimen and the presence of adjunctive procedures. A series of Chi-square tests were performed to compare characteristics between those with symptoms and those without. Logistic regression models were generated to estimate odds ratios of reporting menopausal symptoms. RESULTS: A total of 90 patients were enrolled in the study with a mean age of 33.06 years. Majority (81.1%) reported at least one menopausal symptom. The most prevalent symptoms were psychological symptoms, followed by somatic, then urogenital problems. Among those with an intact uterus, 8.2% reported permanent amenorrhea. Only Stage III/IV and the presence of total hysterectomy were significantly associated with menopausal symptoms. The presence of menopausal symptoms was significantly associated with poorer health-related QoL among the respondents. CONCLUSION: Menopausal symptoms are prevalent among young GTN survivors, and these negatively affect their health-related QoL. Emphasis should be placed on recognizing and addressing these symptoms. Adjunctive procedures, especially hysterectomy, should be carefully considered because these are significantly associated with menopausal symptoms.