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Menopause is when a woman's ovaries stop releasing eggs, either because of age or certain cancer treatments. It usually begins during a woman's mid-40s to mid-50s. During natural menopause, a woman's body makes less of the hormones estrogen and progesterone, causing irregular menstrual periods that eventually stop. Cancer treatment, such as surgical removal of the ovaries, chemotherapy, hormonal or anti-estrogen treatments, and radiation therapy to the pelvic area, may also cause menopause, usually at an earlier age than expected.
The symptoms and signs of menopause caused by cancer treatment depend on type of treatment you receive and your health history. Relieving side effects, also called symptom management, palliative care, or supportive care, is an important part of cancer care and treatment. Talk with your health care team about any menopausal symptoms you experience, including any new symptoms or a change in symptoms.
- Hot flashes, especially in women who are receiving chemotherapy or taking tamoxifen (Nolvadex) or one of the aromatase inhibitors (such as anastrazole [Arimidex], exemestane [Aromasin], or letrozole [Femara]) to prevent breast cancer recurrence (return of the cancer)
- Night sweats
- Vaginal dryness, itching, irritation, or discharge
- Painful sexual intercourse
- Reduced libido and interest in sexual activity
- Difficulties with bladder control
Although estrogen or progesterone treatment may help with hot flashes and osteoporosis (thinning of the bones; see below), these hormones are not usually recommended for someone with a cancer influenced by hormones (such as breast cancer). This is because of the possibility that they may contribute to cancer growth.
Hot flashes. The following treatments may help relieve hot flashes:
- Some antidepressants, such as venlafaxine (Effexor) and paroxetine (Paxil), at a very low dose
- Vitamin E supplements and clonidine (Catapres), a blood pressure medication
- Deep breathing and other relaxation techniques
- A cooler room temperature
- Soy supplements have not been proven to relieve hot flashes, but they are not usually recommended for women who have estrogen receptor-positive cancers (cancers that use estrogen to grow).
Osteoporosis. A loss of estrogen increases the risk of osteoporosis. The following activities may help reduce the risk of developing osteoporosis:
- Perform weight-bearing exercise, such as walking 20 to 30 minutes per day.
- Maintain an ideal body weight.
- Consider taking vitamin D and calcium supplements. Current recommendations for vitamin D are 600 international units (IU) per day for women ages 1 to 70 and 800 IU per day for women older than 70. The recommendations for calcium supplements are 1,000 milligrams (mg) per day for adults aged 19 to 50 and 1,200 mg per day for women 51 and older.
In addition, your doctor may recommend a bone density test or offer other medications, such as alendronate (Fosamax), calcitonin (multiple brand names), or raloxifene (Evista,).
Vaginal dryness. Vaginal lubricants, estrogen creams, or estrogen rings may help relieve vaginal dryness. There are many products available, and you may need to try several to find one that works best for you and your partner. Using an estrogen ring may not be the best choice for women with estrogen-positive breast cancers, so talk with your doctor before using an estrogen ring.
Last Updated: January 24, 2012