Chemotherapy is a foundation of cancer treatment, but its impact goes beyond targeting cancer cells. For many individuals undergoing chemotherapy, one significant consequence is chemo-induced menopause. This blog looks at the unique challenges of menopause triggered by chemotherapy, exploring its relevance in scenarios like ovarian cancer, postmenopausal ovarian cancer symptoms, and menopause after hysterectomy. We uncover the various signs and symptoms of menopause that individuals may experience during or after chemotherapy, offering insight into what to expect and how to manage these changes effectively. Whether you’re undergoing treatment yourself or supporting a loved one through this journey, understanding the common symptoms of chemo-induced menopause is key to navigating this phase of surviving cancer with knowledge and resilience. This can help you to ask your medical team the important questions.

What is chemo-induced menopause?

Chemo-induced menopause refers to the onset of menopause-like symptoms triggered by chemotherapy treatment. Chemotherapy can damage ovarian follicles and disrupt hormone production, leading to a decline in oestrogen levels and the start of menopausal symptoms. Unlike natural menopause, which occurs gradually, chemo-induced menopause can happen suddenly and more intensely due to the abrupt stop of ovarian function. In a recent survey we conducted with University College London Hospital, we found that 90.4% of the women surveyed entered menopause as a direct result of their cancer treatment. Understanding the distinctions between these two types of menopause is important for individuals undergoing chemotherapy and healthcare providers to manage symptoms and provide appropriate support.

Ask the expert

Our medical advisor Mr Talaulikar, associate specialist at the reproductive medicine unit at University College London Hospitals, explains the challenge of treatment-induced menopause. “Cancer treatment – whether surgery, chemotherapy or radiotherapy – can suddenly plunge a woman into temporary or permanent menopause regardless of age. This abrupt change means she usually suffers far more severe menopausal symptoms than a woman who has naturally gone through the menopause”. He explains: “In a natural menopause, levels of the hormone oestrogen naturally drop off over time as a woman moves through the perimenopause, (the time before the menopause when her ovaries gradually stop working) to the full menopause (when her periods finally stop for good), and can take between two and five years.”

He adds, “But cancer treatment can cause oestrogen levels to plummet in a matter of days, weeks or months, triggering the menopause. With chemotherapy, you can also go quickly into menopause within three or four months – this is because chemotherapy drugs are designed to seek and destroy dividing cells and do not differentiate between cancer cells and the follicles containing a woman’s eggs, which are also very active. As a result, these are also destroyed during treatment.

For a woman aged around 20 – who has a large number of eggs remaining and only has mild chemotherapy – her store will reduce. But for a woman in her late thirties, chemotherapy will wipe out her store of eggs.”

Signs and symptoms of menopause after hysterectomy

Menopause can occur after a hysterectomy, especially if the surgery involves the removal of the ovaries (oophorectomy). Without the ovaries, the body no longer produces oestrogen and progesterone, leading to hormonal changes similar to those experienced during natural menopause. Common symptoms of menopause after hysterectomy include hot flushes, night sweats, vaginal dryness, mood swings, and changes in libido. Menopause after a hysterectomy due to a cancer diagnosis may differ from natural menopause in several ways.

Mr Talaulikar explains: ‘If you have surgery to remove your ovaries, hormonal changes will happen very quickly, within 24 hours, and you will be plunged straight into the menopause.

The onset of symptoms may be more abrupt, and individuals may experience more intense symptoms due to the sudden loss of ovarian function. Plus, the psychological impact of undergoing cancer treatment and surgical interventions can make emotional symptoms such as anxiety and depression worse. Understanding these differences is important for individuals and healthcare providers to effectively manage menopausal symptoms after a hysterectomy and provide appropriate support. We know that many women are not prepared for the surgical onset of menopause and its effects on the body. Many reveal that they had no warning, signposting or help, and had to figure it all out by themselves. 

Understanding climacteric symptoms

Climacteric symptoms, often referred to as menopausal symptoms, include a wide range of physical and emotional changes that happen during the menopausal transition. These symptoms result from hormonal fluctuations, particularly a decline in oestrogen levels, and can significantly impact quality of life. Common climacteric symptoms include hot flushes, night sweats, vaginal dryness, mood swings, insomnia, and cognitive changes. When undergoing chemotherapy, these symptoms can be worse due to the added impact of chemotherapy on hormonal balance and overall physical health. 

Chemotherapy-induced menopause can make climacteric symptoms more intense, leading to more frequent and severe hot flushes, increased fatigue, and heightened emotional distress. 

It’s important for people going through cancer treatment and healthcare providers to understand how chemotherapy can make climacteric symptoms worse. This understanding helps in managing symptoms and boosting well-being during this tough period.

We have a menopause symptom checker which you can download for free HERE. Determining whether symptoms stem from cancer treatment or menopause can be challenging. Use this checklist to monitor symptoms, facilitate informed discussions with your medical team, and track your symptoms over time. Consider bringing it to appointments for reference. 

Coping with psychological effects of chemo-induced menopause

Coping with the psychological effects of chemo-induced menopause presents a big challenge for individuals undergoing cancer treatment. The sudden onset of menopausal symptoms, coupled with the emotional toll of chemotherapy, can worsen feelings of anxiety, depression, and loss of control. Many individuals experience distressing emotions related to changes in body image, sexuality, and fertility, further impacting their mental well-being. 

Coping strategies such as mindfulness practices, therapy, and support groups can help individuals deal with these psychological challenges and build resilience. Open communication with healthcare providers and loved ones can provide much-needed emotional support and validation. By acknowledging and addressing the psychological impact of chemo-induced menopause, individuals can take proactive steps towards maintaining their mental health and overall well-being throughout the cancer journey.

Managing symptoms of chemo-induced menopause

Managing the symptoms of chemo-induced menopause can be challenging, but there are various strategies to help ease discomfort and improve quality of life. For example, it’s been shown that people who maintain a healthy BMI tend to have fewer hot flushes, so it’s important to make lifestyle changes, such as maintaining a healthy diet, staying hydrated and exercising regularly. Please don’t let the BMI statistic upset you; we know how hard it can be and also depressing when you have tried so much to tackle stubborn weight gain and it doesn’t seem to be shifting. Check out our podcast episode with dietician Nigel Denby on the Menopause and Cancer podcast, which is all about weight loss after cancer treatment. Listen HERE. Practising stress-reduction techniques like yoga or meditation and breathwork can also help manage symptoms like hot flushes, mood swings, and fatigue.

What’s more, medical treatments such as hormone replacement therapy (HRT), where appropriate, antidepressants, or medications specifically targeting hot flushes, can provide relief for some individuals. Natural remedies like herbal supplements, acupuncture, or dietary changes may also offer symptom relief for others. Individuals need to work closely with their healthcare providers to explore the most suitable combination of strategies for their unique needs and preferences. By proactively managing symptoms through a holistic approach, individuals can better cope with the challenges of chemo-induced menopause and improve their overall well-being.

Navigating chemo-induced menopause

Recognising and addressing chemo-induced menopause symptoms is vital for enhancing the quality of life during cancer treatment. Consulting healthcare providers for personalised advice and treatment options provides effective symptom management tailored to individual needs. By seeking support and guidance from trusted professionals, individuals can handle chemo-induced menopause with greater comfort and resilience, ultimately improving their overall well-being throughout the cancer journey.  Embracing a proactive approach to managing symptoms empowers people to actively participate in their treatment and maintain control over their health, fostering a more positive outlook during this challenging time.

Join our community

Share your experiences, insights, or queries with our community who understand what you’re going through. Stay informed about chemo-induced menopause and related topics by subscribing to the Menopause and Cancer newsletter, joining the conversation in our active Facebook group, or regularly following our blog updates. Let’s grow a supportive community where we can exchange knowledge, offer encouragement, and manage the difficulties of chemo-induced menopause together. Your contributions play an important role in enriching our understanding of the challenges that come after cancer treatment and helping those affected feel supported and seen. 

Join the conversation

Share your experiences, connect with others dealing with menopause after cancer, and seek reliable information and support from trusted sources. Consider subscribing to the Menopause and Cancer newsletter or podcast for ongoing updates and community support on related topics. Your voice matters, and together we can navigate this journey feeling strong, empowered and perhaps most important – not alone.

Get your voice heard

Now, we want to hear from you. Share your experiences in our Facebook group, and let us know how you’d like to be supported during menopause. By listening to each other and offering a helping hand, we can create a caring and inclusive community for women going through this journey. Together, let’s stand by each other with compassion and kindness.

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