During Treatment

The menopause and hormone therapy

Posted by Sara Liyanage on 04 October 2017

As if you haven’t had enough thrown at you by now, let’s just throw in the menopause for good measure just to make sure that life is really shitty. And because it is prematurely imposed by the treatment, its symptoms can be more intense than a natural menopause. Oh that is just great. Thank. You. Very. Much.

Chemotherapy can bring on an early menopause in some women. Sometimes it can bring on a temporary menopause and periods re-start a few months after chemotherapy ends.

Hormone treatment can also bring on an early menopause or mimic a menopause.

Note that not every woman will experience the menopause due to breast cancer treatment. Your oncologist will talk this through with you.

Symptoms and tips for dealing with the menopausal symptoms and side effects of hormone therapy

These vary from person to person, and not everyone will get all symptoms.

Sara notes that she started to notice menopausal symptoms early on during chemo, but sometimes it was hard to tell what was down to chemo and what was down to the menopause. It was all just a mixing pot of general crapiness.

We’ve listed to most common menopausal symptoms together with some practical tips for coping with them. It’s important to discuss these with your chemo nurses, oncologist or GP as they will be able to provide advice.

Hot flushes and night sweats

Hot flushes during the day and night sweats can be triggered by certain things such as caffeine, alcohol and spicy foods. Try to work out what your triggers are so that you can cut down these things. For night sweats you can keep a small can of water spray next to your bed, have a fan in the bedroom and use a specially designed cooling pillow. Bamboo nightwear can also help because it is highly breathable, absorbent and temperature regulating. If you are sweating at night and having to change clothes in the middle of the night then wearing this might help. Speak to your oncology team as they may be able to suggest other ways of helping with hot flushes and night sweats, such as acupuncture and medication.

Bone density 

The menopause, as well as Aromatase Inhibitor hormone therapy, can affect your bone density over time and can lead to osteoporosis and its precursor, osteopenia. To help prevent this, the advice is to:

  • ensure you have enough vitamin D and calcium in your diet – check with your GP/oncologist about whether supplements are suitable for you and you may wish to consider taking advice from a specialist registered dietician or nutritionist about which supplements would help; 
  • do gentle weight bearing exercises – again check with a professional if you have had recent surgery, are now at risk of lymphoedema, or having treatment;
  • stop smoking; 
  • avoid excess alcohol; and 
  • keep to a healthy weight.

It’s worth talking to your oncology team about having Dexa scans to monitor your bone strength and in some circumstances additional bone strengthening medication may be necessary.

Menopause can increase your chances of developing osteoporosis. Breast Cancer Now have a booklet covering any concerns that you may have and it can be ordered or downloaded here. You may wish to look at the Royal Osteoporosis Society website and this helpful article.

Brain fog

It’s common to experience brain fog as a result of the menopause or hormone therapy.  This brain fog can be confused with lingering chemo brain if you’ve only recently completed chemotherapy. They both cause the same fogginess and inability to recall names or words, and inability to use your brain as you used to before cancer. Exercise can help, as can CBT and mindfulness to reduce stress. It’s worth understanding that if you’re experiencing brain fog, you might need to adapt how you work and how you live generally. For example, avoid multitasking, make to-do lists, and don’t arrange meetings at times of the day when the brain fog is at its worst. There is an increasing awareness and acknowledgement by the medical profession of this symptom and a number of hospitals and clinics offer courses to help.

Weight gain

This is a particularly prevalent side effect of Tamoxifen.  With less oestrogen entering the cells of your body, your metabolism slows down and you can put on weight more easily – especially around the waist. And it can be really hard to lose this weight. But, it is possible by exercising – especially weight bearing exercises – and making healthy changes to your diet. It’s advisable to take professional advice from your oncology team or a registered dietician about making changes to your diet. 

Aching joints

Aching joints are often worse in the morning but they can improve over the course of the day with increased exercise and movement. To help with aching joints, keep yourself active within your limits: do plenty of exercise but recognise that you may not be able to exercise at the same level as pre-cancer. It’s worth consulting your oncology team to ask for advice on supplements and acupuncture.

Vaginal dryness

It is very common to experience vaginal dryness which can lead to painful or uncomfortable sexual intercourse as well as general discomfort. Ask your GP or oncology team about safe vaginal lubricants and moisturisers to use to help with the vaginal dryness. Don’t be embarrassed to talk to your oncology team about this side effect because early, regular use of vaginal moisturisers and additional lubricants prior to intercourse can really help. Check out this Expert Advice on sex during/after breast cancer.

Anxiety 

For advice on coping with increased anxiety, take a look at our page on Coping With Anxiety and Other Mental Health Issues.

Disturbed sleep and insomnia

For advice on getting a better night sleep look at The Insomnia Clinic.

Emotional rollercoaster

You might find yourself feeling UP and DOWN all the time: crying for no reason, losing your confidence, more anxious and experiencing mood swings!

What is the menopause and what is a chemo side effect?

The following symptoms of the menopause are so similar to my chemo side effects that it can be tricky trying to work out what is down to what, so we’ve have added some links to some super helpful information about how to help them:

Breast Cancer Now have information on periods stopping
CRUK have information on the effects on memory
CRUK have information on fatigue and tiredness
CRUK have information on weight gain
CRUK have information on decreased sex drive
Breast Cancer Now have information on vaginal dryness

Fertility

If you have not had children and you are embarking on breast cancer treatment then you will need to discuss fertility issues with your oncologist. There is a Breast Cancer Now booklet on fertility which you can order or download from here. 

Helpful resources and more information

Macmillan – managing menopausal symptoms 

Cancer Research UK – breast cancer and menopausal symptoms

Breast Cancer Now booklet

Menopause Matters is a website providing up-to-date information about the menopause, menopausal symptoms and treatment options. It is not breast cancer related. It may give you some information on how to manage your symptoms.

There is an excellent article in the Telegraph called “Your guide to dealing with chemotherapy induced menopause”. Go to www.telegraph.co.uk and search for the title.

NHS Bridgewater Community Healthcare information sheet on the menopause

Menopause Support: is a website providing lots of information and support for women going through the menopause (non-cancer related).

Other excellent websites dedicated to dealing with the menopause are these ones but note that sometimes the advice for menopausal women who have had breast cancer is different to the advice to those who have not (for example HRT is usually not advised for women who’ve had breast cancer).

Henpicked

Positive Pause

Live Better With…menopause (products to help during the menopause)

Dr Hannah Short, General Practitioner and accredited Specialist in Menopause & Premenstrual Disorders, shared her top tips with her in this information sheet.

Reviewed August 2021

The information and content provided on this page is intended for information and educational purposes only and is not intended to substitute for professional medical advice.

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