Menopause occurs when one of the following happens:

• A woman’s ovaries stop producing eggs
  
  
• Her menstrual periods become irregular then stop completely
  
  
• Her body decreases production of the hormones estrogen and progesterone

Menopause begins during a woman's mid-40s to mid-50s. It can also begin before a woman’s 40s if cancer treatment has stopped the ovaries from working (called premature menopause). Up to 40% of women experience menopausal symptoms because of breast cancer or breast cancer treatments. Menopausal symptoms depend on the type of chemotherapy a woman receives and may include the following:

• Hot flashes, especially in women who are taking tamoxifen (Nolvadex) to prevent breast cancer recurrence (return of the cancer)
  
  
• Night sweats
  
  
• Vaginal dryness, itching, irritation, or discharge
  
  
• Painful sexual intercourse
  
  
• Difficulties with bladder control
  
  
• Depression
  
  
• Insomnia

Managing symptoms: hot flashes

Estrogen or progesterone treatment for women may help with hot flashes and osteoporosis (thinning of the bones), but often the goal of breast cancer treatment is to remove these hormones. Therefore, estrogen and progesterone are not usually recommended because there is a possibility that they may speed up the growth of the cancer. The following treatments may help relieve hot flashes:

• Some antidepressants,s uch as venlafaxine (Effexor) and paroxetine )Paxil)
  
  
• Vitamin E supplements and clonidine (Catapres), a blood pressure medicationExercise
  
  
• Deep breathing and other relaxation techniques
  
  
• A cooler room temperature

Soy supplements have not been proven to relieve hot flashes. In addition, vaginal lubricants, estrogen creams, or estrogen rings may help relieve vaginal dryness.

Managing symptoms: osteoporosis

Hormone treatments for breast cancer remove estrogen from the body. However, 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.
  
  
• Take vitamin D supplements (400 to 800 international units [IU] per day) and calcium supplements (1500 milligrams [mg] per day for women without previous osteoporosis, 2000 mg per day for women with previous osteoporosis), but be sure to talk with your doctor before taking supplements.

In addition, your doctor may recommend a bone density test or offer other medications, such as alendronate (Fosamax), calcitonin (Calcimar, Cibacalcin, or Miacalcin), or raloxifene (Evista).

More Information

Sexual Dysfunction

Menopause and Cancer Risk and Treatment

Managing Side Effects

Additional Resources

Lance Armstrong Foundation: Osteoporosis

Cancersymptoms.org: Hormonal Disturbances

Last Updated: September 25, 2009