If you’re having cancer treatment as a younger woman, you may experience an early menopause. This could be temporary or permanent depending on your treatment. It can feel an additional challenge when you’re dealing with everything else.
Treatments that trigger the menopause include surgery to the ovaries, radiotherapy to the pelvis, some types of chemotherapy, and hormone therapy. There may be a loss of fertility for women of a child bearing age, either for a time during and after treatment, or in somes cases, permanently.
The symptoms you experience may be more intense than during a natural menopause, as the hormone supply is being stopped suddenly. Symptoms include hot flushes and sweating, vaginal dryness, fatigue, poor concentration, difficulty sleeping, low mood and periods stopping.
Menopausal symptoms usually reduce after a couple of years as your body becomesused to the drop in the hormone oestrogen. Hormone replacement therapy can help relieve symptoms, but is not recommended for some types of cancer, including breast cancer.
The information on this page will help you to find out more about the menopause and cancer. We’ll focus on ways to help manage the symptoms, including how Maggie’s can support you.
Menopause and cancer explained
If you’re going through cancer treatment and having periods, you may find that the disruption to your hormones causes an early menopause. In some cases, the menopause will only be temporary, but for others it will be permanent. It depends on the type of treatment you’re having, and how near you are to the natural menopause.
Normally, the menopause is a natural process which happens as a woman reaches her early 50’s. It is caused by the change in a woman’s hormones as she gets older. It’s often a significant milestone, as periods gradually stop, and pregnancy is no longer possible.
Symptoms include hot flushes and sweats, fatigue, vaginal dryness, poor concentration, mood changes and low mood. You may find the texture of your hair and skin changes, and some women have headaches, aching joints. It can also affect your sex life and libido, which can be an additional upset at a time when you may be feeling vulnerable.
The symptoms are often more intensely experienced when the menopause is caused by treatment, as your hormone supply will stop more suddenly. It happens with some types of chemotherapy, surgery, radiotherapy and hormone therapy. This particularly (but not exclusively) can affect women with gynaecological and breast cancer. Even If you’ve been through the menopause already, it is still possible to experience symptoms again, especially with some of the hormone treatments for breast cancer.
Some of you may have natural concerns about the impact of your cancer treatment on your fertility, whether you were planning a family in the near future or not. It is important to raise your concerns early on, before treatment starts. Measures to preserve your fertility, if possible, can be discussed at this point. The emotional impact of loss of fertility can be very difficult - and it is understandable that you may need extra support at this point.
Managing the menopause and cancer
An early menopause can seem another huge step, in a life already affected by cancer and its treatments. However, there are a variety of things you can do to help relieve the symptoms and cope with the hormonal and emotional dips the menopause may bring:-
- Find out from your healthcare team about the treatment you’re having, and whether this will cause an early menopause. You may have a list of questions, about whether the menopause will be temporary or permanent, and the possible impact on your fertility.
- If you’re on treatment, and you’re noticing the symptoms of the menopause are severe do talk things through with your doctor and/or specialist nurse. There are a number of ways the symptoms can be managed - but the team needs to know about how the menopause is affecting you.
- Whilst the doctors can help by prescribing medications which may help reduce some of your symptoms you may also like to think about options to help yourself too. Stress management, relaxation, gentle exercise, massage and acupuncture can be effective.
- Work out your triggers: Hot flushes, in particular, can be set off by a hot room, spicy food, hot drinks, restrictive clothing, stress and anxiety. (See our webpage - hot flushes and cancer, for further advice on managing this symptom).
- A common symptom is vaginal dryness, which can be uncomfortable, cause bladder infections and impact on your sex life. At a time when you may already be lacking confidence with intimacy, this can feel an additional stress. Talk to your GP or specialist nurse about creams and lubricants that can help ease the symptoms. They may be able to prescribe pessaries or creams that contain a small amount of oestrogen. The dose that is absorbed systemically (by the whole body) is minimal.
- You may find you put on weight. This can feel demoralising, especially as you may feel you have no control over the situation. A healthy, balanced diet and exercise plan can help to take some control back and be better for your general health too.
- Mood swings, feeling irritable, anxious or depressed can affect women going through menopause. Concentration can also be a problem. These symptoms are temporary for many, but if your emotions and mood are causing you distress, don’t ignore it. Some of the mood changes, and loss of concentration can be due to a number of issues, including treatments you’re on or just completed, stress, fatigue, etc. Speaking with your healthcare team and opening up to family and friends and finding support can help - this might be through a local cancer support group, at our Maggie’s Centres and here online.
- You may have been on HRT (hormone replacement therapy) before your cancer diagnosis. In many cases HRT will be stopped, particularly if your cancer is hormone sensitive ( such as breast or endometrial cancer, for example). Stopping HRT suddenly can bring on a surge of menopausal symptoms. In fact, any treatment induced menopause, particularly if you’re in your twenties or thirties, can cause intense symptoms. It can feel a lot to deal with, on top of your cancer treatment. Ask your health care team how they will monitor your bone and heart health in the years post menopause.
- You may have read about various supplements: red clover, black cohosh, isoflavones and soya products, and there is still ongoing debate about whether they should be taken by women with breast cancer. Other products like evening primrose oil or sage are sometimes suggested. Before taking any of these products, do check with your team, as some of the supplements can interfere with your cancer treatments.
The three key tips that can help you cope with a treatment induced menopause are to focus on healthy eating, regular exercise, and learning to relax and de-stress.
Your local Maggie’s Centre can help in all these areas. Drop in and ask about our nutrition and healthy eating workshops.
Find out about the range of activities on offer that can help with both body and mind - and have a safe space to talk through how you feel.
When to seek further help
- There are so many symptoms that interlink and it can be hard to tell at times whether it is the treatment, other medications or the menopause causing how you feel. If you notice any new symptoms, or are concerned in any way, do check them out.
- If you notice vaginal spotting or bleeding, after your periods have stopped, it’s important to see your GP or hospital health care team, as some treatments can cause this problem.
- For some women, the menopause can add to feelings of low self esteem, anxiety and depression. If these symptoms are affecting you on a daily basis, and you’re finding coping emotionally difficult - there is support out there. Talk to your doctor and healthcare team, and explain how you feel. It’s sometimes hard to reach out for support, but it can be a positive step to recovery.