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Abstract
Menopause is part of a woman’s natural aging process when her ovaries produce lower levels of the hormones estrogen and progesterone and when she is no longer able to become pregnant. The average age for menopause is 52 years. However, menopause commonly happens anytime between the ages of 42 and 56. A woman can say she has begun her menopause when she has not had a period for a full year (Jane, 2004).The woman’s age is a significant factor of breast cancer as the risk of breast cancer increases with age. Older women especially those over 55 years are at highest risk. There has been some evidence to suggest that long-term hormonal replacement therapy in postmenopausal women increase the risk of breast cancer (Giselle, 2000). In recent years, there has been a significant decrease in breast cancer mortality (Wingo et al., 1999). According to the recommendations of the National Institutes of Health Consensus Conference on Adjuvant Therapy of Breast Cancer, the reasons for this is decreasing in breast cancer mortality return to the more widespread utilization of mammography as well as the successful dissemination and utilization of adjuvant therapy (NIH Consensus Development Program, 2000 <Menopausal symptoms are common and problematic for women receiving adjuvant chemotherapy for breast cancer (Myra et al., 2004). So assessment of the menopausal symptoms during chemotherapy for breast cancer is important to assist the woman throughout the treatment and provide suggestions about strategies to mange these symptoms. The present study aimed to determine if menopausal symptoms in women who are undergoing systemic chemotherapy for breast cancer differ from those in women who experience a natural menopause. It is conducted at Faculty of Medicine, Clinical Oncology Department, Menoufiya University. The study is conducted on 120 women and includes two main groups a study group and a control group. The study group, which included 60 women at early stages of breast cancer and received chemotherapy treatment. The control group, which included 60 women achieved normal menopause and has not received chemotherapy and hormonal replacement therapy. Women in both groups were perimenopausal and postmenopausal (age above 40 years). The data are collected from Faculty of Medicine, Clinical Oncology Department.Three tools were designed by the researcher for this study to collect data from each subject in the study setting. One of the tools was taken from foreign source (Green and cooke, 1980) and translated into Arabic to be suitable to our Egyptian community. These tools included the following: 1) An interview questionnaire form that includes sections for sociodemographic data, obstetrical history, family history and medical history. 2) Information about breast cancer disease and chemotherapy,menstrual history and the present complaints related to menopause. 3) A lickert scale design was adopted and translated from the Green Climacteric scale. It was simplified to have three score levels (frequently scored 3, sometimes-scored 2 and rarely scored 1).The scale consisted of 20 items measuring physiological and psychological aspects of menopause. Eligible women were identified from the registration book found in the out-patient clinic regarding inclusion criteria of the study. Each women was interviewed individually once by the researcher in the out patient clinic or during the chemotherapy session. Women in control group were taken from the gynecological out patient clinic. Each interview was completed during a period of 20 minutes starting from July 2007 to October 2007.Human right and ethical considerations were observed and considered in conducting the study. The purpose of the study was explained to each woman in the sample. The investigator approached each woman, giving her an overview of the study, and explained the procedures. Before inclusion in the study sample, each woman gave her oral informed consent to participate. She was informed that participation in the study is voluntary, and that she can withdraw from the study whenever she decides to. Total confidentiality of the obtained information, as well as respect of the subject’s privacy was ensured. The main study findings of the present study were: 1- There was a statistically significant difference between peri menopausal women who have undergone systemic chemotherapy for breast cancer treatment and perimenopausal women who experience natural menopause regarding frequency and severity of menopausal symptoms as follows. - The prevalence of tachycardia, sleeplessness, numbness, joint pain, and decreased in hand sensation was statistically significant higher among perimenopause women in the case group (38.89, 36.11 %, 27.78 %, 25.00 % & 52.78 % respectively) than perimenopause women in the control group (10.53 %, 13.16 %, 15.79 %, 5.26 % & 23.68 %respectively). (P < 0.05).- The prevalence of excitement, fear, difficult concentration, and decreased enjoyment was statistically significant higher among perimenopause women in the case group (47.22 %, 47.22 %, 36.11 % & 36.11 % respectively) than perimenopause women in the control group (2.63 %, 13.16 %, 5.26 % & 5.26 % respectively). (P<0.001). - Moreover, perimenopausal women in the case group showed significantly higher prevalence of unhappiness, crying attacks, anger, and headache (50.00 %, 38.89 %, 36.11 &52.78 % respectively) than perimenopausal women in the control group (2.63 %, 5.26 %, 5.26 % 18.42 % addition, prevalence of dyspnea, hot