Rate of abnormal vaginal bleeding and contraception counseling in women undergoing chemotherapy

Kristin E. Cutler, Mitchell D Creinin, Jay Michael S Balagtas, Melody Hou

Research output: Contribution to journalArticle

Abstract

Background Reproductive-age women who are undergoing cancer treatment are at risk for heavy menstrual bleeding, unintended pregnancy, and have a contraindication to estrogen-containing products.The incidence of vaginal bleeding and contraception use is not known. Objective To describe clinical practices regarding menstrual suppression, estimate the incidence of vaginal bleeding complaints, and investigate contraceptive counseling and provision in women undergoing chemotherapy. Methods We performed a chart review using ICD-9 codes to identify women aged 14-40 years who received chemotherapy at our institution during July 2008-June 2013. Electronic medical records were examined for menstrual suppression therapy, contraception counseling, and abnormal vaginal bleeding. Results We identified 137 women for this study. 24 (18%) received prophylactic menstrual suppression counseling, of whom 17 (71%) initiated treatment, primarily with combined oral contraceptives, all prescribed by hematologist-oncologists. During the first 6 months of chemotherapy, 36 women (26%) complained of abnormal vaginal bleeding, including 10 women who were on prophylactic treatment. 19 women noted moderate to severe bleeding. 11 (12%) women received contraceptive counseling before chemotherapy, all from hematologist-oncologists; 86 women (63%) initiated chemotherapy without a documented contraceptive method. Limitations Data were generated from billing codes, so all eligible women may not have been included. Conclusions Reproductive-age women undergoing chemotherapy may not receive adequate contraception and menstrual suppression counseling. We encourage consulting gynecologists, especially family planning specialists, at the time of cancer diagnosis to support women with decisions about menstrual suppression and contraception.

Original languageEnglish (US)
Pages (from-to)337-341
Number of pages5
JournalJournal of Community and Supportive Oncology
Volume14
Issue number8
DOIs
StatePublished - Aug 1 2016

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Uterine Hemorrhage
Contraception
Counseling
Drug Therapy
International Classification of Diseases
Contraceptive Agents
Hemorrhage
Contraceptives, Oral, Combined
Electronic Health Records
Incidence
Family Planning Services
Therapeutics
Neoplasms
Estrogens

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Rate of abnormal vaginal bleeding and contraception counseling in women undergoing chemotherapy. / Cutler, Kristin E.; Creinin, Mitchell D; Balagtas, Jay Michael S; Hou, Melody.

In: Journal of Community and Supportive Oncology, Vol. 14, No. 8, 01.08.2016, p. 337-341.

Research output: Contribution to journalArticle

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abstract = "Background Reproductive-age women who are undergoing cancer treatment are at risk for heavy menstrual bleeding, unintended pregnancy, and have a contraindication to estrogen-containing products.The incidence of vaginal bleeding and contraception use is not known. Objective To describe clinical practices regarding menstrual suppression, estimate the incidence of vaginal bleeding complaints, and investigate contraceptive counseling and provision in women undergoing chemotherapy. Methods We performed a chart review using ICD-9 codes to identify women aged 14-40 years who received chemotherapy at our institution during July 2008-June 2013. Electronic medical records were examined for menstrual suppression therapy, contraception counseling, and abnormal vaginal bleeding. Results We identified 137 women for this study. 24 (18{\%}) received prophylactic menstrual suppression counseling, of whom 17 (71{\%}) initiated treatment, primarily with combined oral contraceptives, all prescribed by hematologist-oncologists. During the first 6 months of chemotherapy, 36 women (26{\%}) complained of abnormal vaginal bleeding, including 10 women who were on prophylactic treatment. 19 women noted moderate to severe bleeding. 11 (12{\%}) women received contraceptive counseling before chemotherapy, all from hematologist-oncologists; 86 women (63{\%}) initiated chemotherapy without a documented contraceptive method. Limitations Data were generated from billing codes, so all eligible women may not have been included. Conclusions Reproductive-age women undergoing chemotherapy may not receive adequate contraception and menstrual suppression counseling. We encourage consulting gynecologists, especially family planning specialists, at the time of cancer diagnosis to support women with decisions about menstrual suppression and contraception.",
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