Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 14;33(11):945.
doi: 10.1007/s00520-025-10041-7.

Longitudinal trajectory of menopausal symptoms in premenopausal women throughout adjuvant chemotherapy: a two-stage analytical approach

Saim Jung  1 , Jaehyun Kim  2 , Sun Hyung Lee  2   3 , Joon Sung Shin  2 , Won-Hyoung Kim  4 , Dooyoung Jung  5   6   7 , Tae-Yong Kim  8   9 , Seock-Ah Im  8   9   10 , Kyung-Hun Lee  8   9 , Bong-Jin Hahm  2   3   11 , Chan-Woo Yeom  12
Affiliations

Longitudinal trajectory of menopausal symptoms in premenopausal women throughout adjuvant chemotherapy: a two-stage analytical approach

Saim Jung et al. Support Care Cancer. .

Abstract

Purpose: Breast cancer incidence in Asian women peaks in the mid-40 s, when many remain premenopausal. The progression of chemotherapy-induced menopausal symptoms in this population remains underexplored. This study examined their temporal trajectory and clinical significance during adjuvant chemotherapy.

Method: This prospective study assessed breast cancer patients undergoing adjuvant chemotherapy at a tertiary hospital. Participants were classified by menopausal status and treated with AC-D (Adriamycin, Cyclophosphamide, and Docetaxel) or FAC (5-Fluorouracil, Adriamycin, and Cyclophosphamide) regimens. Menopausal symptoms were evaluated using the Menopausal Rating Scale (MRS) at four time points: before chemotherapy (T0), after the first (T1) and fourth (T2) cycles, and one month post-chemotherapy (T3). Symptom trajectories were analyzed using a linear mixed-effects model (LMM) and Generalized Estimating Equations (GEE).

Results: Menopausal symptoms significantly worsened in premenopausal women (AC-D: p < 0.001, FAC: p < 0.001), particularly from T2 onward. Psychological symptoms showed the greatest increase (AC-D: p < 0.001, FAC: p < 0.001), followed by significant worsening of urogenital symptoms (AC-D: p = 0.002, FAC: p = 0.004). Somatic symptoms showed a non-significant increasing trend (AC-D: p = 0.120, FAC: p = 0.101). At T3, 67.9% of AC-D and 59.4% of FAC patients experienced moderate-to-severe symptoms, with severe cases doubling in AC-D (from 16.1% at T0 to 37.5%) and tripling in FAC (6.8% at T0 to 18.9%).

Conclusion: Chemotherapy-induced menopausal symptoms progressively worsened, particularly psychological symptoms. By treatment completion, approximately two-thirds required clinical intervention, underscoring the need for early assessment and proactive management to improve patient outcomes.

Keywords: Adjuvant chemotherapy; Breast cancer; Chemotherapy-induced menopausal symptoms; Menopausal rating scale; Premenopausal.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Biomedical Research Ethics Committee of Seoul National University Hospital (Seoul, South Korea) and was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study. Consent for publication: All authors of this study have agreed to submit and publish it in this journal. Conflicts of interest: The authors declare no competing interests.

References

    1. Group, E.B.C.T.C. (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365(9472):1687–1717 - DOI
    1. Torino F et al (2014) Chemotherapy-induced ovarian toxicity in patients affected by endocrine-responsive early breast cancer. Crit Rev Oncol Hematol 89(1):27–42 - DOI - PubMed
    1. Sonmezer M, Oktay K (2006) Fertility preservation in young women undergoing breast cancer therapy. Oncologist 11(5):422–434 - DOI - PubMed
    1. Tiong V et al (2014) Incidence of chemotherapy-induced ovarian failure in premenopausal women undergoing chemotherapy for breast cancer. World J Surg 38:2288–2296 - DOI - PubMed
    1. Swain SM et al (2010) Longer therapy, iatrogenic amenorrhea, and survival in early breast cancer. N Engl J Med 362(22):2053–2065 - DOI - PubMed - PMC

MeSH terms

Supplementary concepts

LinkOut - more resources