Menopause occurs when a woman’s ovaries stop releasing eggs, either because of age or specific cancer or other medical 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. Some types of cancer treatment, such as the surgical removal of the ovaries, chemotherapy, hormone or anti-estrogen treatments, and radiation therapy to the pelvic area, may also cause menopause, often 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 is an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Talk with your health care team about any menopausal symptoms you experience, including new symptoms or a change in symptoms.
Symptoms and signs of menopause are caused by shifts in estrogen and progesterone, and they may include the following:
- Hot flashes are sudden instances of body heat, flushing, and sweating, which usually go away after a few minutes. These often occur in women who receive chemotherapy and drugs such as tamoxifen (Nolvadex) or aromatase inhibitors, which are drugs that reduce the amount of estrogen in a woman's body by stopping tissues and organs other than the ovaries from producing it, such as anastrazole (Arimidex), exemestane (Aromasin), and letrozole (Femara)
- Night sweats
- Vaginal dryness, itching, irritation, or discharge
- Painful sexual intercourse
- Reduced libido (desire for sexual activity)
- Thinning of the bones, called osteoporosis
- Bladder control difficulties
- Depression and mood swings
Keep in mind that many unpleasant symptoms of menopause will eventually diminish and disappear.
Consider these options for managing hot flashes:
- Practice relaxation techniques, such as deep breathing, and other strategies to reduce stress.
- Keep a cool room temperature.
- Dress in layers, allowing you to adjust clothing during and after hot flashes.
For some women, it may be appropriate to take medications (such as low-dose antidepressants) or supplements, but only after talking with your doctor about the risks and benefits.
The following options may help you manage or prevent osteoporosis:
- Perform weight-bearing exercise, such as walking 20 to 30 minutes per day.
- Maintain an ideal body weight.
- Take vitamin D and calcium supplements. Talk with your doctor to learn the current recommended dosage for these supplements, based on your age.
In addition, your doctor may recommend a bone density test or suggest medications, such as alendronate (Fosamax), calcitonin (multiple brand names), or raloxifene (Evista).
For vaginal dryness, consider using vaginal lubricants, estrogen creams, or using an estrogen ring. You may need to try several products to find one that works best for you and your partner. In addition, talk with your doctor before using an estrogen ring because it may not be the best choice for women with ER-positive breast cancers.
Although combined hormone therapy (a combination of estrogen and progestin, which is a form of progesterone that is made in a laboratory) may help relieve menopausal symptoms such as hot flashes and osteoporosis, doctors typically do not recommend the treatment for most women. For women who have a history of breast cancer or those who have a higher risk of breast cancer, hormone therapy may contribute to cancer growth and increase the risk of other medical conditions. Sometimes, a woman may receive low doses of hormone therapy for a short time. Hormone therapy with estrogen alone is a consideration only for women who have had a hysterectomy (surgical removal of the uterus).
The effects of combined hormone therapy on women are controversial, and the risks and benefits of the treatment are different for each woman. Research in this area is ongoing. If you are considering hormone therapy for menopausal symptoms, talk with your doctor about your specific symptoms, medical history, and options for relieving the symptoms. Learn more about menopausal hormone therapy and cancer risk.