Impact of treatment induced premature menopause on quality of life following hematopoietic cell transplantation

Background. Reports in the literature describe excellent quality of life (QOL) in hematopoietic cell transplant (HCT) recipients despite ongoing physical and psychological sequelae. Response shift is a theoretical model offering an explanation of how individuals following HCT can maintain or improve their QOL. Women under the age of 50 will experience premature menopause as the result of the high dose preparatory regimen utilized for HCT. Premature menopause can negatively affect sexuality and QOL.; Purpose. The specific aim of this study is to describe the impact of treatment induced premature menopause on sexuality and QOL in women following HCT.; Methods. This longitudinal descriptive study is designed to assess menopausal symptoms, sexuality and QOL in women in the first year following transplant. The following self-report instruments were used (1) Menopause-Specific Quality of Life, (2) Female Sexual Function Index, (3) Psychosocial Adjustment to Illness Scale, (4) a global QOL score recorded on a 100 mm line and (5) a demographic and medical survey. The influence of premature menopause on the change in sexuality and QOL over time will be analyzed using repeated measures analysis of variance.; Findings. An analysis of 33 women, pre-HCT reveals that all are experiencing symptoms of menopause. The mean number of menopausal symptoms is 17 +/- 6 with a range of 6 to 28. Findings indicate that all phases of the sexual response cycle are altered. In the entire sample, 76% report decreased libido and 46% are dissatisfied with their overall sex life. The 19 sexually active women reported problems with arousal (37%), lubrication (32%), pain (21%), and orgasm (42%). There are statistically significant correlations between symptoms of menopause, altered sexual health and QOL. In a subset analysis of 20 couples prior to HCT, findings indicate that both members of the dyad are experiencing stress. On two domains (extended family relationships and social environment), the spouses/partners are experiencing more distress than the transplant candidates. The mean QOL score of the transplant candidates is 67 +/- 30 and the mean QOL score for the spouses/partners is 73 +/- 23. These QOL scores were not significantly different.