Menopause, a natural phase marking the end of a woman’s reproductive years, can be a challenging transition on its own. However, when cancer treatments intervene, triggering menopause prematurely, the impact can be profound. This blog delves into how cancer treatments such as chemotherapy, surgery, or radiotherapy can speed up the onset of menopause and make symptoms worse. We explore the physical and emotional toll this can take on individuals, highlighting the importance of understanding and managing this aspect of surviving cancer. Join us as we uncover the reasons behind cancer-induced menopause and discover the support available for those embarking on this difficult journey.

So, if you have a suitcase full of symptoms you’re dragging around, what’s happening and how you feel is normal given the situation your body is in. But, there is so much we can do to make the journey less draining. 

 

Understanding menopause

Menopause marks the end of a woman’s menstrual cycle, typically between 45 and 55, and is characterised by a decline in oestrogen and progesterone production, leading to various physical and emotional symptoms. Hot flushes, night sweats, vaginal dryness, mood swings, and sleep disturbances are common symptoms. Menopause is diagnosed in retrospect and once you have not had any periods for 12 months. 

Plus, changes in bone density and increased risk of heart disease may occur. Natural menopause occurs as a result of ageing, while medically-induced menopause can be triggered by cancer treatments like chemotherapy, surgery to remove ovaries, anti-hormone treatment or radiation therapy to the pelvis. Understanding the differences between these two types of menopause is important for effective management and support. 

However, all too often, we hear women say they were not prepared for the menopause that followed their cancer treatment, and some even felt like menopause after cancer was like sinking into a big black hole. That’s why we’re here to show you there is light at the end of the tunnel. 

 

How cancer treatments trigger menopause 

Cancer treatments can disrupt the delicate hormonal balance in the body, leading to premature or immediate menopause in individuals undergoing therapy. Here’s how different treatments contribute to triggering menopause:

  • Surgery: Procedures such as oophorectomy, the surgical removal of one or both ovaries, can abruptly stop oestrogen and progesterone production. Since these hormones play a central role in regulating menstrual cycles, their sudden absence results in an immediate onset of menopause. Women undergoing oophorectomy often experience intense menopausal symptoms due to the sudden hormonal changes.
  • Chemotherapy: Certain chemotherapeutic agents, particularly those used in treating breast and gynaecological cancers, can damage the ovarian follicles responsible for hormone production. This damage can lead to a decline in ovarian function, resulting in temporary or permanent menopause. The severity and length of menopausal symptoms experienced during chemotherapy can vary depending on factors such as the type and dosage of chemotherapy drugs given.
  • Radiation therapy: Pelvic radiation therapy, commonly used in the treatment of gynaecological and colorectal cancers, can inadvertently affect ovarian function by exposing the ovaries to radiation. This exposure can reduce ovarian reserves, leading to a decline in hormone production and subsequent menopausal symptoms. The extent of ovarian damage and the likelihood of menopause depends on factors such as the radiation dose and how close the ovaries are to the treatment area.
  • Hormone therapy: Some cancer treatments, particularly those aimed at hormone-sensitive cancers like breast cancer, involve therapies that block or suppress hormone production. For example, anti-oestrogen therapies such as tamoxifen or aromatase inhibitors are commonly used in breast cancer treatment. These medications can induce menopause-like symptoms such as hot flushes, vaginal dryness, and mood swings by disrupting oestrogen-signalling pathways in the body. 

 

Our medical advisor Mr Vikram Talaulikar, associate specialist at the reproductive medicine unit in University College London Hospitals NHS Foundation Trust, explains, ‘‘With chemotherapy, you can also go quickly into the 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.” He adds, “For younger women, who have a huge 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.”

 

Factors influencing menopause onset in cancer patients 

Several factors influence the likelihood and timing of menopause starting in cancer patients undergoing treatment. Age plays a significant role, as younger patients may be more resilient to ovarian damage caused by cancer therapies compared to older people. The type of cancer and specific treatments received also affect when menopause can kick in. 

For example, cancers affecting the reproductive organs or those treated with aggressive chemotherapy are more likely to experience premature menopause. Plus, genetics or pre-existing reproductive health issues can impact the onset of menopause. Women with a family history of early menopause or underlying conditions affecting ovarian function may be more susceptible to experiencing menopause earlier in life. Understanding these factors is important for healthcare providers to tailor treatment plans and provide full support to cancer patients dealing with the beginning of menopause.  

 

Managing symptoms and health post-cancer-induced menopause 

After experiencing menopause induced by cancer treatment, individuals may face a range of physical and emotional challenges. Hot flushes go hand in hand with menopause; in fact, around two-thirds of postmenopausal women with a history of breast cancer deal with hot flashes and 44% of these women are associated with night sweats. 

Effective management strategies can greatly improve the quality of life during this transition. Hormone replacement therapy (HRT) is a common approach to ease menopausal symptoms by replenishing declining hormone levels. However, its suitability depends on factors such as cancer type and treatment history, so consultation with healthcare providers is important. Lifestyle changes, including regular exercise, a healthy diet, stress management techniques, and adequate sleep, can also help reduce symptoms and promote overall well-being.

It’s most important that you understand if your treatment is likely going to induce menopause so that you can ask for the right help. Mr Talaulikar explains, ’Sometimes I see women who have been suffering with horrendous menopause symptoms, including hot flushes, mood swings and depression, for 12 or 18 months. Often they are suitable for HRT and could have enjoyed a good quality of life in that time”.

As well as physical care, addressing mental health is also important. Many individuals may struggle with feelings of loss, anxiety, having to come to terms with loss of fertility, or depression following cancer-induced menopause. Seeking counselling or support groups can provide valuable emotional support and coping strategies. Counselling sessions can help individuals navigate the emotional challenges of adapting to life after cancer and menopause, supporting resilience and empowering individuals to embrace their new normal. By integrating holistic approaches to symptom management and prioritising mental health support, individuals can handle menopause after cancer with more grit and improved overall well-being.

 

Resources and support systems

With a recent survey carried out in collaboration with University College London Hospital, we found that a massive 92% of women who entered menopause as a direct result of their cancer treatment felt isolated in their experiences. This is why these individuals need to access support networks and reliable resources. 

When the founder of Menopause and Cancer, Dani Binnington, realised that there was nothing available to support her on her own journey as a young cancer patient pushed into menopause a decade before natural menopause typically kicks in, she decided to do something about it. Dani set up the first Facebook group for those affected by menopause and cancer, empowering individuals to navigate this journey with confidence and resilience.

“I knew that support groups and online forums offer opportunities to connect with others facing similar challenges, share experiences, and receive emotional support, and that’s so important,” says Dani. In the Menopause and Cancer Facebook group, you’ll find a supportive community of people who’ve faced the same or similar challenges and are willing to rally around when it matters most. 

Healthcare providers specialising in menopausal care can provide personalised guidance and treatment options tailored to individual needs. Plus, podcasts like Menopause and Cancer offer valuable insights and information on navigating menopause post-cancer. 

 

Menopause after cancer: Understanding treatment impact

As we’ve outlined, cancer treatments can significantly impact menopause onset and symptoms, affecting both physical and emotional well-being. Surgical interventions, chemotherapy, radiation therapy, and hormone therapies all play a role in triggering menopause prematurely. However, proactive management strategies, including hormone replacement therapy where appropriate, lifestyle adjustments, and mental health support, can help individuals manage this transition with resilience. It’s worth seeking support from healthcare providers specialising in menopausal care and exploring available resources and support networks. We’ve outlined how you can access menopause specialist care in the UK in an article here. By taking proactive steps and seeking tailored care, individuals can optimise their health and quality of life after cancer-induced menopause.

 

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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