Introduction: should ovarian failure in survivors of childhood cancers be treated with hormonal therapy?

摘要

Radiation and chemotherapy can have a profound effect on ovarian function. Children exposed to cancer treatments may experience delayed puberty, transient ovarian insufficiency, or early onset ovarian failure. Historically, the concern for morbidity associated with a hypoestrogenic state has resulted in therapeutic endeavors to exogenously administer estrogens in an effort to restore the normal hormonal milieu. The use of hormone replacement therapy in survivors of childhood cancers facilitates the development of secondary sexual characteristics, improves libido, counters the impaired sense of well-being associated with a hypoestrogenic state, and may prevent associated psychosexual dysfunctioning. From a medical standpoint, estrogen replacement improves bone mineral density which may be decreased as a result of permanent ovarian failure or as a function of cancer treatments, de novo. As with any therapeutic measure, the risks and benefits must be considered.