Psychological distress of prematurely menopausal cancer survivors

Abstract

While hormone replacement therapy (HRT) is currently prescribed to offset the physical, emotional, and sexual consequences of premature menopause related to successful cancer treatment, little is known about the overall adjustment of these women. This study sought to examine the factors that contribute to psychological distress in prematurely menopausal cancer survivors by employing the following two designs: First, the nature and severity of difficulties were examined among 34 women (ages 24-46) receiving HRT for treatment-induced menopause by comparing them to 24 healthy, female acquaintances with normal menses (ages 25-45) on several indices of well-being, including physical, sexual, psychological, and interpersonal. Second, a predictive model of psychological distress was examined in the prematurely menopausal cancer survivors. This model hypothesized that psychological distress will be directly influenced by the level of menopause-related physical symptomatology and sexual disturbance, with relationship adjustment acting as a moderator of physical and sexual symptom-related distress. The following measures were used: The Menopause Symptom Checklist, The Sexual History Structured Interview, The Brief Symptom Inventory, and The Dyadic Adjustment Scale. Between-group analyses indicate that prematurely menopausal cancer survivors experienced more menopause-related physical symptoms (p {dollar}<{dollar}.05), a higher prevalence of clinical sexual dysfunction (p {dollar}<{dollar}.05), and greater psychological distress (p {dollar}<{dollar}.05) than the normal-menses women. As predicted, groups did not differ on relationship adjustment. Within-group analyses indicate that menopause-related physical symptoms significantly predicted psychological distress (p {dollar}<{dollar}.05), but sexual dysfunction did not. Contrary to prediction, relationship adjustment did not have an influential effect on the interrelationships between physical/sexual symptoms and distress. Despite receiving hormone replacement therapy, prematurely menopausal cancer survivors demonstrate poorer physical, sexual, and psychological functioning in comparison to their healthy peers. This implies that interpersonal resources may be ineffective in the face of menopause-related as well as illness-related mechanisms of distress. Clinical intervention needs to include closer medical follow-up, as well as psychological and sexual rehabilitation in the management of treatment-induced premature menopause.