One of the side effects of breast cancer treatment is early-induced menopause, which can either be permanent or temporary. For patients close to the age of natural menopause, these changes are more likely to be permanent.
Menopausal symptoms can be challenging to deal with, especially while you’re receiving treatment for breast cancer. Fortunately, there are many options, ranging from lifestyle changes to medication, that can help you manage these symptoms.
Breast cancer treatments that can induce menopause
Many of the treatments for breast cancer can cause menopause, including:
- Chemotherapy: Certain types of chemotherapy can cause early menopause by damaging the ovaries. Symptoms can begin immediately or several months after your treatment.
- Hormone-based therapies: Some breast cancer treatments work by stopping your body from producing estrogen and progesterone, which can induce symptoms of menopause.
- Oophorectomy: Ovary removal is sometimes used to treat hormone-dependent breast cancers, which will lead to immediate, permanent menopause.
In general, the symptoms of treatment-induced menopause are more intense than those of natural menopause and can last longer.
Read more about breast cancer treatment and care
Managing menopausal symptoms in breast cancer
The symptoms of menopause can affect the entire body. Depending on your symptoms and preferences, there are many steps you can take to help manage the effects of menopause.
Lifestyle changes
Both alcohol and tobacco use are associated with the development of osteoporosis. Smoking has also been significantly linked with vasomotor symptoms of menopause, which include hot flashes. Breaking these habits—or cutting back if complete cessation isn’t possible—can be extremely helpful.
Physical activity is also recommended for individuals experiencing menopause. It has been shown to improve quality of life by improving mood, reducing fatigue and easing joint pain.
Exercise can reduce the symptoms of cancer treatments, too. However, you should never push yourself. Treatment can be very hard on the body, and exercise might not be possible some days. If you’re feeling up to it, try some light stretching or short walks and see how you feel afterwards. Yoga or tai chi can also improve physical and mental well-being.
Setting up a consistent, relaxing bedtime routine may also be useful. Try avoiding screens and large meals right before bed. Melatonin has also been shown to improve sleep quality in people with breast cancer.
Non-hormonal treatments
Studies have shown that clonidine and some selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) can be used to alleviate hot flashes during menopause in patients with breast cancer. Gabapentin and oxybutynin can also treat hot flashes.
SSRIs and SNRIs are antidepressants and can help treat anxiety, depression and mood changes, all of which can occur during menopause. Duloxetine, an SNRI, has been shown to reduce joint pain in patients with breast cancer as well.
Topical non-hormonal treatments exist to treat symptoms of vaginal dryness and irritation.
Counseling
Several types of counseling can be of use while navigating menopause-related challenges. Those facing psychological symptoms may benefit from cognitive-behavioral therapy, which focuses on goal-setting and shifts in mindset. Sexual counseling and couples therapy are also available.
Why hormone therapy isn’t always recommended
Doctors don’t always recommend hormone replacement therapy for patients with breast cancer who are experiencing symptoms of menopause. This is because some types of breast cancer are hormone-dependent, and supplementing the body with more hormones can potentially increase the risk of recurrence. However, the existing data on this relationship is mixed.
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