Breast cancer is a challenging journey, one that often involves treatments aimed at eradicating the disease and preserving overall health. However, what’s not often discussed is how these treatments can lead to significant changes in a woman’s hormonal balance, ultimately triggering menopause. In fact, in one of our recent surveys, in collaboration with University College London Hospital, we found that a whopping 90.4% of the women surveyed began menopause as a direct result of their cancer treatment. 

In this blog post, we’ll explore medically and surgically induced menopause following breast cancer treatment, shedding light on its impact and offering guidance on managing its symptoms. Understanding these types of menopause is important for women undergoing breast cancer treatment, as it empowers them to navigate this aspect of their journey with knowledge and confidence.

 

Understanding menopause after breast cancer treatment

Understanding menopause after breast cancer treatment is important for women facing this journey. Menopause, typically occurring between 45 and 55 years old, signifies the end of menstrual periods and a decline in oestrogen, progesterone and testosterone production. But, for those undergoing breast cancer treatment, menopause can strike unexpectedly due to some therapies. 

Before menopause, ovaries produce oestrogen, progesterone and testosterone, regulating monthly cycles. Treatments like chemotherapy, ovarian surgery, endocrine therapy or pelvic radiotherapy can induce early menopause by disrupting ovarian function. 

In contrast, natural menopause evolves gradually, while medically or surgically induced menopause can occur more suddenly. Medical professionals can clarify whether treatment might induce early menopause. Understanding this empowers women to navigate menopause after breast cancer treatment, allowing them to make informed decisions and access appropriate support and management strategies. Through conversations with numerous individuals in our community, we’ve discovered that the primary issue for many is the lack of preparation for the profound impact that menopause would have on them.

 

Medically induced menopause

Medically induced menopause is a consequence of cancer treatments that disrupt ovarian function, abruptly halting the production of oestrogen, progesterone and testosterone. Common breast cancer treatments such as chemotherapy and hormonal therapy can speed up this process, causing symptoms like hot flushes, mood changes, and vaginal dryness to occur.

The duration of medically induced menopause can vary from woman to woman, influenced by factors such as the type and length of treatment. While some may experience temporary menopause, for others it may be permanent. Factors like age and individual hormone levels can also impact the duration of medically induced menopause. Understanding this is essential for women undergoing breast cancer treatment, as it enables them to anticipate and manage the physical and emotional challenges associated with this sudden hormonal shift. If you’re on treatments like tamoxifen or aromatase inhibitors you might also experience symptoms as a result of side effects from the medication. We have a brilliant YouTube webinar with breast oncologist Dr. Claire MacCaulay recorded on how to navigate these cancer medications and we highly recommend you watch it for more information here.

 

Surgically induced menopause

Surgically induced menopause happens when surgeries such as hysterectomy or oophorectomy remove the ovaries, suddenly stopping hormone production. Unlike natural menopause, which may occur gradually, surgically induced menopause happens immediately following surgery, with symptoms manifesting quickly.

The permanence of surgically induced menopause depends on the extent of ovarian removal. While a hysterectomy alone may not induce menopause, removing both ovaries will undoubtedly trigger it. This sudden hormonal shift following surgery leads to a range of menopause symptoms which require careful management.

After undergoing surgical menopause, hormone replacement therapy (HRT) is often prescribed to alleviate symptoms. Oestrogen therapy is typically recommended, and, for those with a uterus, progestogen may also be needed. Also, testosterone therapy may be beneficial for addressing symptoms like low mood, reduced energy, and low libido, although it’s not licensed for women in the UK. We do know, however, that for many women in our community hormone therapy might be contra-indicated and so this makes the management of menopause more complex. A multi-faceted approach is needed and we explain more of that in our Youtube crash course here. 

Overall, surgically induced menopause brings about hormonal changes that can significantly impact a woman’s physical and emotional well-being and, of course, will impact future health, which is another reason we need to address this. Seeking specialist support and discussing management options with healthcare professionals are important in navigating this sudden change. Symptoms can be intense, and the long-term health implications, such as the risk of osteoporosis, highlight the importance of tailored care and ongoing support for women experiencing surgically induced menopause.

 

Symptoms of the menopause after hysterectomy

Experiencing menopause after a hysterectomy, whether due to natural ageing or surgery, can bring on a range of symptoms similar to traditional menopause. Things like hot flushes, vaginal dryness, and mood swings might catch you off guard because of the sudden stop in ovarian function.

Symptoms of menopause after hysterectomy can be particularly severe due to the abrupt loss of ovarian function in both pre/post-menopausal women, although current evidence characterising this is limited. 

Vasomotor symptoms, sexual dysfunction, increased risk of cardiovascular and osteoporotic disease, and loss of fertility are some of the common consequences. Libido loss can be more prominent than in natural menopause as well. Leaning on your support system and being informed about resources that can help you through menopause after a hysterectomy is key. 

 

Managing menopause symptoms after breast cancer treatment

Managing menopause symptoms after breast cancer treatment involves exploring various strategies tailored to individual needs. For breast cancer survivors unable to use hormone treatments, non-hormonal options provide a safe alternative. These may include medications like selective serotonin reuptake inhibitors (SSRIs), lifestyle changes, and complementary therapies such as acupuncture or yoga.

Managing hot flushes is crucial, given that they affect around two-thirds of postmenopausal women with a breast cancer history, often accompanied by night sweats in 44% of cases. Practising a slow, controlled breathing method has been shown in two research trials to effectively reduce the number of hot flushes a woman gets by an average of 50% to 60%. 

Lifestyle changes, such as maintaining a healthy diet and keeping physically active, can also contribute to symptom management and overall well-being. Regular follow-ups with healthcare providers are also important, for monitoring symptoms and addressing concerns promptly. These check-ins allow for adjustments to treatment plans as needed. But, again, we understand access to care is a huge problem and many people say they have not been able to ask their doctors about all the things they need support with. 

Support systems are crucial in navigating this phase, providing emotional support and practical help. Open communication with healthcare providers means that individuals receive tailored care and guidance throughout their menopausal journey after breast cancer treatment.

 

The role of support and information

Community support plays a vital role in empowering women facing menopause after breast cancer treatment. Menopause and Cancer provide invaluable resources, including podcasts, online workshops, and support groups, encouraging a sense of belonging and understanding. By sharing experiences and tips for coping with menopause symptoms, women can navigate this journey together, finding strength in solidarity and support.

 

Discover support for menopause after breast cancer

Navigating menopause after breast cancer treatment presents unique challenges, but it’s important to remember that support and resources are available. By understanding medically and surgically induced menopause and exploring effective management strategies, women can embrace this new chapter with resilience and hope. It’s more difficult to find information tailored to you, but we believe that small changes can have a big impact and sometimes just knowing that we have options can be a positive thing!

 

Join our community today

As one of our recent surveys in collaboration with University College London Hospital also found that a staggering 92% feel isolated in their experiences, we invite you to share your experiences or questions in the comments below and join the Menopause and Cancer community today for continued support and up-to-date resources. You can also sign up for our newsletter to keep updated on upcoming events, webinars, and support group meetings tailored to your needs. 

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