Hormone replacement therapy regimens in chemotherapy-induced premature ovarian failure and the subsequent correction of hormone levels

Neuro Endocrinol Lett. 2012;33(7):697-702.

Abstract

Objectives: Premature ovarian failure (POF) is a consequence of gonadotoxic chemoradiotherapy given in antyneoplasia treatment. In young women it will correlate with menopausal symptoms which tend to appear due to depleted ovarian follicle reserve.

Design: It was a case series study that included women 18-50 years old who were treated for malignancy with gonadotoxic chemioradiotherapy. We have measured blood hormonal levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and progesterone within one month of various hormone replacement therapy (HRT).

Results: We have observed different kind of hormonal reaction according to FSH, LH, estradiol and progesterone levels due to various hormonal replacement therapy. The administration of various HRT regimens presented with a decrease in the blood concentration of estradiol E2 and progesterone and a concomitant increase of FSH and LH. These findings demonstrate a shift to physiological ranges and a simultaneous improvement of symptoms associated with CI-POF.

Conclusions: The most appropriate therapy needs to be selected according to the patient's alleviation of symptoms and correction of blood hormone levels.

MeSH terms

  • Adolescent
  • Adult
  • Chemoradiotherapy / adverse effects*
  • Contraceptive Agents, Female / administration & dosage
  • Drug Combinations
  • Dydrogesterone / administration & dosage
  • Estradiol / administration & dosage
  • Estradiol / blood
  • Estriol / administration & dosage
  • Female
  • Follicle Stimulating Hormone, Human / blood
  • Hematologic Neoplasms / therapy*
  • Hormone Replacement Therapy / methods*
  • Humans
  • Infertility, Female / blood
  • Infertility, Female / chemically induced
  • Infertility, Female / drug therapy
  • Luteinizing Hormone / blood
  • Medroxyprogesterone Acetate / administration & dosage
  • Megestrol / administration & dosage
  • Megestrol / analogs & derivatives
  • Middle Aged
  • Ovarian Follicle / drug effects
  • Primary Ovarian Insufficiency / blood
  • Primary Ovarian Insufficiency / chemically induced*
  • Primary Ovarian Insufficiency / drug therapy*
  • Progesterone / blood
  • Progesterone Congeners / administration & dosage
  • Young Adult

Substances

  • Contraceptive Agents, Female
  • Drug Combinations
  • Follicle Stimulating Hormone, Human
  • Progesterone Congeners
  • femoston
  • nomegestrol
  • Progesterone
  • Estradiol
  • Luteinizing Hormone
  • Dydrogesterone
  • Medroxyprogesterone Acetate
  • Megestrol
  • Estriol