Menopausal Symptoms in Women

Approved by the Cancer.Net Editorial Board, 01/2019

The ability for a woman to become pregnant and have a child ends naturally in her 40s or 50s. Your body makes less and less of the hormones that help you have children, and your ovaries stop releasing eggs. Your menstrual periods change over time. Eventually, you stop having periods.

Menopause is usually a natural process. The time until your periods stop can be a few months or several years. But some cancer treatments can also cause menopause, sometimes much earlier than the usual age. If this happens, there are many different treatments available. They include hormone treatments and treatments without hormones.

Menopause from cancer treatment

Treatments that can cause menopause include:

  • Surgery to remove the ovaries

  • Chemotherapy, which may cause damage to the ovaries

  • Hormone treatments or anti-estrogen treatments, which stop the ovaries from producing estrogen

  • Radiation therapy in the area around the hips, or pelvic area

Ask your health care team if your cancer treatment could cause menopause. If you still want to have children, talk to your doctor about ways to do this even if treatment causes menopause.

How do I know if I might be going through menopause?

Symptoms and signs of menopause include:

  • Hot flashes, which is when you suddenly feel hot and sweaty. Your face, chest, and other areas might feel very hot. These usually go away in a few minutes.

  • Night sweats, which result in waking up at night soaked in sweat

  • Vaginal dryness, itching, irritation, or discharge

  • Pain or other changes with sex

  • A condition called osteoporosis in which the bones become thinner and more likely to break

  • Bladder control problems, including needing to urinate often, having difficulty holding urine, or leaking

  • Urinary tract infections

  • Depression, anxiety, irritability, and mood swings

  • Sleep problems

You are more likely to have hot flashes and vaginal dryness from chemotherapy, tamoxifen, and drugs called aromatase inhibitors. These include the drugs anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara).

Coping with menopause from cancer treatment

Talk with your health care team if you think you have symptoms related to menopause. They can discuss options to manage your symptoms.

Many menopause symptoms go away after your periods end. But many women have symptoms for several years or more. About 1 out of every 3 women has menopause symptoms for 10 years or longer. But you do not just have to live with symptoms that bother you. Lifestyle changes and treatment can help, so tell your doctor if you have any concerns or notice new symptoms. You can also talk with your women's health doctor, called a "gynecologist" or an "OB/GYN," or a doctor who specializes in caring for women in menopause or with cancer.

Here are some ways to cope with specific menopause symptoms.

Coping with hot flashes

The following may help you cope with hot flashes. Talk with your health care team about the best options for you.

  • Hypnosis or cognitive behavioral therapy

  • Weight loss

  • Mindfulness-based activities, such as meditation

Coping with thinner bones

  • Do exercises where you support your own body weight, such as walking for 20 to 30 minutes each day. Ask your doctor about other exercises.

  • Maintain a healthy weight

  • Your doctor can tell you if you need to take calcium, vitamin D, or both. You can have a blood test to check the levels in your blood. 

  • Your doctor might have you get a type of X-ray called a bone density test. This test measures how thick your bones are in specific places, usually your hips and spine. If you have osteoporosis or are likely to get it, you might need to take medicine to help strengthen your bones.

Coping with vaginal and bladder changes

Your vagina might become thinner, drier, and more sensitive during menopause. This can happen whether your menopause is from cancer treatment or getting older.

Sex might hurt because you have little or no natural moisture. You might also have itching or irritation, and it might be more difficult to hold your urine.

Ask your doctor about treatment options. These may include moisturizers or lubricants you put in the vagina. Other vaginal treatments include:

  • Estrogen cream

  • A small ring, pill, or gel cap that contains estrogen

  • A hormone called DHEA

You might also try a medicine called ospemifene (Osphena) that you take by mouth. Tell your doctor if one option does not work well. You might need to try several before you find the right treatment or combination of treatments.

Your cancer doctor can work with your OB/GYN to help you find the best option. Some cancers, such as estrogen receptor-positive breast cancer, are affected by hormones. This means that some treatments are safer than others for you.

Medicines without hormones

Medicines without hormones can help some symptoms of menopause, including hot flashes and mood changes. These medicines include some that help depression and anxiety, such as fluoxetine (Prozac), venlafaxine (Effexor), and others. Gabapentin (Gralise, Neurontin) can help with hot flashes and sleep problems. Your doctor might prescribe these medicines if you cannot safely take hormones or prefer not to take them.

Hormone treatments

Your doctor can prescribe estrogen in the form of a pill, patch, spray, or gel, or as a small ring you wear inside your vagina. These treatments can help you cope with symptoms caused by low levels of natural estrogen. For example, they can relieve hot flashes and help with thinning bones, or osteoporosis. Many treatments approved by the U.S. Food and Drug Administration work the same way as the estrogen your body used to make.

Doctors call these treatments menopausal hormone therapy, or MHT. They are also known as hormone replacement therapy, or HRT. But doctors no longer recommend hormone therapy for most women because it can raise your risk of certain conditions. So, your doctor will probably prescribe just enough to help your symptoms. If you still have your uterus, your treatment should include a hormone called progesterone along with the estrogen. This keeps the lining of the uterus from growing too much.

The risks and benefits of hormone therapy are different for each person. Ask your doctor if hormone therapy is right for you, or if treatment for specific symptoms of menopause can help. Talking with your cancer doctor and OB/GYN can help you find the best options for treating menopause symptoms and discomfort.

Related Resources

Long-Term Side Effects of Cancer Treatment

Sexuality and Cancer Treatment: Women

More Information

North American Menopause Society

National Institute on Aging: What is Menopause?