Prevalência de alterações no ciclo menstrual em mulheres em idade fértil submetidas à quimioterapia no município de São Luís, Maranhão

Abstract

Introduction: Irregularities in menstrual cycles and fertility can be determined by several factors and are particularly disturbing in women who are still of childbearing age and who have undergone chemotherapy treatment (QT). Many chemotherapy drugs are gonadotoxic, significantly modifying the reproductive system causing from gynecopathies to other endocrine diseases (in conception), resulting in ovarian failure and precipitating climacteric symptoms. Objective: To assess the incidence and prevalence of amenorrhea and other menopausal symptoms in women undergoing cancer treatment. Methodology: This is a cross-sectional study based on the selection of 47 women who were still undergoing cancer treatment, aged between 18 and 44 years, in two public cancer referral hospitals in the State of Maranhão. From February 2019 to July 2019, a structured form was applied by the research team containing questions about sociodemographic variables, clinical data and treatment, menstrual cycle and climacteric symptoms. Data were analyzed using the Creative Research Systems program. Results: The epidemiological profile was characterized by the average age between 19 and 45 years, “non-white” skin color (68.18%), family income above 1 minimum wage (97.72%), marital status indicates “lives with a partner” (65.90%), complete and incomplete high school education (72.72%), non-smokers (86.36%). The mean age at menarche was ≥ 13 years (59.09%), they had one to three pregnancies (68.18%). Amenorrhea was reported during QT treatment (61.36%) and of these, 27.27% did not return to menstruation after the last treatment cycle. Regarding climacteric symptoms, 63.63% (28/44) reported having had some symptom, with 40.4% with hot flashes and 31.9% had sweating, 34% reported vaginal dryness and 4.3% had dyspareunia. The most prevalent type of cancer was breast (63.63%). In the sample population the increase in the number of chemotherapy cycles was not associated with the presence of amenorrhea and hot flashes. Conclusion: Among women with amenorrhea, 29.6% used microtubule inhibitory chemotherapeutics and those with climacteric disorders predominated the same drug with 34.6%. The reproductive history registered 57.4% with menarche at 13 years of age, 72.3% denied abortion. In the statistical study through the regression model, amenorrhea was found (2.759-CI95% 0.671-11.44-p>0.05), and hot flushes (1.362-CI95% 0.289-6.409-p>0.05) indicating that it did not was related to the number of chemotherapy cycles.