Managing your Symptoms of Menopause after Cancer Treatment
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Managing your Symptoms of Menopause
after Cancer Treatment
UHN
Information for women who have finished treatment
Read this handout to learn about:
• What are the symptoms of menopause?
• Will my periods come back?
• What helps to manage the symptoms?
• Where can I learn more?
Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca
© 2013 University Health Network. All rights reserved.
This information is to be used for informational purposes only and is not intended as a substitute for professional
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Author: Dr. Sarah Ferguson, Dr. Doris Howell, Stephanie Bertin and the ELLICSR Research Team
Created: 05/2013
Form: D-5767After your cancer treatment, you may have symptoms of menopause. Your
hormone levels may drop and you may stop having periods. You may have
other symptoms as well.
Women usually go through menopause in their late 40s to early 50s.
However, some treatments for cancer can cause early menopause. In some
cases, your periods may return. In other cases they will not.
What causes menopause?
Menopause happens when your ovaries make lower levels of hormones.
The main hormones are estrogen and progesterone. At first your periods
become irregular. When the level of estrogen is very low, your periods will
stop completely.
Some cancer treatments can cause early menopause as a side effect. This
is called treatment-induced menopause. In this case, menopause may be
temporary or permanent. It depends on the type of cancer treatment you had,
and other factors.
What are the symptoms of menopause?
Each woman has a different experience of menopause. If your cancer
treatment caused your menopause, you will have the same kind of
symptoms. But, the symptoms may start more quickly.
Here are some common symptoms of menopause. You may have all of
these symptoms or only a few. Every woman is different.
• hot flashes
• night sweats
• problems sleeping, such as not being able to fall asleep
• weight gain
• vaginal dryness or vaginal itching
• some loss of bladder control
• more frequent bladder infections
• mood swings or getting easily irritated
• problems with memory and concentration
2There are also long-term effects of menopause.
These include:
• loss of bone mass or density, leading to osteoporosis
• changes in cholesterol levels and greater risk of heart disease
Will my periods come back?
Sometimes a menopause that starts after cancer treatment can be temporary.
It depends on the type of cancer treatment you had, and other factors such as
your age.
If you had surgery
Women who have surgery to remove both ovaries will go through
menopause.
If you had chemotherapy
Some chemotherapy drugs can stop the ovaries from working normally.
This can lead to menopause. Menopause may be temporary or permanent.
This depends on many factors, such as:
• the type and dose of drug used
• how long your treatment lasted
• your age
If you are close to the age of natural menopause, your menopause is more
likely to be permanent. If you are younger, your periods may return after
treatment.
If you had radiation therapy to the pelvis
Radiation therapy to the pelvis can affect your ovaries and lead to
menopause. This depends on your age and the dose of radiation to the
ovaries. The effect may be temporary or permanent.
If you had hormonal therapy
You may have some symptoms of menopause. For example, you may have
changes in your periods and hot flashes. However this therapy does not
bring on menopause.
3What can help
There are many things you can do to relieve your symptoms.
Symptom What can help?
hot flashes • Wear light clothing in layers.
• Splash cool water on your wrists.
• Vitamin E supplements may help to ease hot flashes and
improve sleep. Ask the doctor if this is right for you. Also ask
how much you should take and how often to take it.
Ask your doctor about medicines that can help with hot flashes.
Some examples are:
• clonidine (Dixarit, Catapres) – a drug used to treat high blood
pressure
• venlafaxine (Effexor) – an antidepressant
• paroxetine (Paxil) – an antidepressant
• fluoxetine (Prozac) – an antidepressant
• gabapentin (Neurontin) – an drug used to prevent seizures
Ask your doctor if these are right for you. Also ask about any side
effects.
sleep • Try drinking warm milk or chamomile tea at bedtime. Avoid
alcohol and caffeine, as they can make your symptoms worse.
• Exercise can help. Do regular physical activity during the day.
This helps to lower stress and improves the way you feel.
• Try relaxation techniques before bed.
continued on next page
4mood swings • Try relaxation techniques to lower your stress levels. Some
or examples are visualization, deep breathing, massage
anxiety or yoga.
• A special type of counselling can be helpful. This is called
cognitive behavioural therapy. Make sure you look for
someone who is trained in this technique.
vaginal • Use a vaginal moisturizer that is water-based.
dryness • Use a vaginal lubricator during sex.
• Having sex regularly may prevent dryness.
bladder To help prevent bladder infections:
problems • Drink lots of fluids.
• Empty your bladder often (especially
after having sex).
• Wear cotton underwear.
• Keep your genital area clean.
bladder To improve bladder control, try Kegel exercises. These exercises
problems use the same muscles that stop the flow of urine. If these muscles
(continued) are stronger, you will have less leaking.
You can do Kegel exercises while sitting, lying or standing:
• Try to draw in or tighten the muscles around the anus. Do not
tighten your stomach, back or thigh muscles.
• Hold this squeeze for 10 seconds and then release slowly.
Think of an elevator going up to the 10th floor and then
coming back down.
• Repeat several times.
• Try to do a set of Kegel exercises every hour while awake.
5What are herbal therapies?
Some women choose to use herbal therapies to help with symptoms of
menopause. We do not know how safe and effective these therapies are.
There has not been enough research on the effects for women with cancer
who are going through menopause.
Some herbal products may interfere with treatments or may be harmful.
Always check with your doctor before taking any herbal product.
Some examples of herbal products:
• evening primrose oil
• ginseng
• black cohosh
• soy products
Soy products contain weak plant estrogens (phytoestrogens).
We do not know what effects these products have on women with
certain types of cancer.
What is hormone replacement therapy?
Hormone replacement therapy (HRT) is sometimes used to help with severe
menopausal symptoms. It can help to manage hot flashes, problems sleeping
and mood swings.
The therapy has benefits and risks, so it is important to discuss this with your
doctor. Some women may choose this therapy if other treatments are not
working for them.
Hormones used:
It is most common to take a combination of 2 hormones: estrogen and
progestin. If you only take estrogen, you have a higher risk of getting cancer
of the uterus.
If your uterus was removed, then you can take estrogen on its own.
6What are the benenefits of HRT?
HRT can have a number of benefits:
• it helps reduce symptoms of menopause
• it protects against osteoporosis (losing bone density)
• it reduces the risk of colon cancer
What are the risks of HRT?
Taking estrogen and progestin for a long time increases the risk of:
• breast cancer
• heart disease
• stroke
• blood clots in the lungs
Researchers now believe that taking these hormones for a long time has
more risks than benefits.
Making a decision with your doctor
Talk to your doctor about the risks and benefits of HRT. Avoid taking these
hormones unless your symptoms are severe and do not improve with other
treatments. Many women feel that HRT is not a good choice for them.
If you and your doctor decide that taking HRT is right for you:
• use the lowest dose
• take it for the shortest period of time possible
7How do I talk to my doctor about my symptoms?
To help you with your symptoms, you will get an appointment with your
family doctor or a gynecologist. Prepare for your appointment, as it may be
short. It can also be hard to remember everything you want to talk about.
To prepare:
1. Keep track of your symptoms. For example, write down how many hot
flashes you have in a day or week. Ask yourself:
a. How severe are your symptoms?
b. Does anything help?
c. Does anything make them worse?
2. Make a list of any medications and vitamin supplements you take. Write
down how much
you take and how often you take them.
3. Prepare a list of questions to ask your doctor. List your most important
questions first, in case time
runs out.
For your appointment:
1. Ask a family member or close friend to come along, if possible. You
may get a lot of information at your visit. It can be hard to remember
everything.
2. Take a notebook or notepad with you. Use it to write down important
information during your visit.
3. Ask the questions you prepared.
4. Make sure you understand what your doctor is saying. To do this, you
can:
a. ask the doctor to repeat the information
b. ask follow-up questions
c. tell the doctor the main things you understood
8What questions should I ask?
• What kind of tests might I need?
• What treatments can reduce my symptoms?
• Is there anything I can do to relieve my symptoms?
• What can I do to maintain my health?
• Do you have any printed information I can take with me?
What websites do you recommend?
What can I do to protect my health?
See your family doctor regularly. Make sure the doctor:
• checks for signs of osteoporosis
• explains what you can do to reduce osteoporosis
• checks your cholesterol
It also helps to have a healthy lifestyle.
Where can I find more information?
About Hormone Replacement Therapy:
Canadian Cancer Society
www.cancer.ca/British%20Columbia-Yukon/Prevention/Artificial%20
hormones/Hormone%20replacement%20therapy.aspx?sc_lang=en
About menopausal symptoms for women with breast cancer:
MacMillan Cancer Support
www.macmillan.org.uk/Cancerinformation/Cancertypes/Breast/
Livingwithbreastcancer/Menopausalsymptoms/Menopausalsymptoms.
aspx
9About menopause:
The North American Menopause Society (NAMS)
www.menopause.org
NAMS is a world leader in menopause information and education. It offers:
• a wide range of resources
• information that is easy to read
• publications such as the Early Menopause Guidebook
Websites about cancer may also have information about menopause. Some
examples are:
• American Cancer Society - www.cancer.org
• groups for your specific type of cancer
10You can also read
