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Commonly encountered symptoms include pain, muscle cramps, sleep disturbances, psychological symptoms, and gastrointestinal issues

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The pathophysiology of DOX-induced POI is complex, but numerous factors have been proposed to be linked to the onset and development of ovarian dysfunction, including free radical-mediated lipid peroxidation, oxidative stress, mitochondrial malfunction, increased proinflammatory release of cytokines, and granulosa cell apoptosis 12,13,14

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The apobec-1 editing complex is expressed in the intestine and edits a specific cytidine to an uracil in the apo B mRNA in the intestine creating a stop codon that results in the cessation of protein translation and a shorter Apo B (Apo B-48)