THE MENOPAUSE

& CANCER

The menopause is a natural and inevitable event for all women. Menopause refers to a woman’s last menstrual period. The average age for the menopause to happen is 52 years with the symptoms lasting over a period of several months to a couple of years.

Cancer treatment & the menopause

Breast cancer treatments such as chemotherapy, hormone treatment or ovarian ablation or suppression can cause menopausal symptoms in pre menopausal women because their ovaries are affected by the treatment. For some this may cause an earlier more sudden menopause. Symptoms are often more intense than when the menopause occurs naturally. However, periods can stop temporarily during chemotherapy and menopausal symptoms may continue until regular periods return. Around 70% of women will have menopausal symptoms during and after treatment for breast cancer.

Fertility

For some women an early menopause may mean coming to terms with the possibility of being infertile. This can be very difficult to cope with especially if you are considering on starting a family or having more children.

Menopausal Symptoms

The more common symptoms of the menopause are: Hot flushes, night sweats, vaginal dryness, palpitations, mood changes, joint pain, changes to skin and hair Women can sometimes put on weight especially in the waist area and may also have difficulty sleeping. A very rare symptom includes experiencing a crawling sensation under the skin, usually under the chest.

Mood changes – it is quite normal to be upset and anxious about your diagnosis and treatment for breast cancer and it is important to be able to talk about your feelings. Reduced levels of oestrogen can affect brain function which can result in lack of concentration and irritability. Women can find themselves short tempered and experience mood changes from feeling positive and happy one day to miserable the next.

Depression – is a common condition and describes a small range of feelings from being low in spirits to having no will to live. Signs of depression can include loss of interest in your appearance, in everyday things, withdrawing from others, feeling more tearful than usual, difficulty sleeping and loss of appetite or over eating. It is important that these feelings are not ignored and you get help.

Joint pain – joint pain or aching joints are common menopausal symptoms and also a side effect of treatment. If women are concerned they should consult their GP’s or breast cancer nurses who can suggest things to help relieve it. Taking pain killers can help such as paracetamol.

Fatigue and tiredness – feeling tired is a common symptom of the menopause and can last for weeks or months and even longer for some women. Fatigue is different from normal tiredness as its more extreme and unpredictable and does not go away with rest or sleep. Research has shown that gentle regular exercise such as walking can help improve your feelings of fatigue.

Changes to skin and hair – the menopause can cause changes in the production of collagen, a protein found in the skin. Low levels of oestrogen leads to the skin becoming dryer, thinner and less elastic. Eating a healthy diet, drinking plenty of water, avoiding very hot showers or baths and scented soap can all help to keep the skin moist. 

MANAGING MENOPAUSAL SYMPTOMS

Hot flushes and night sweats

The frequency of hot flushes can vary for each woman, from a couple per day to a few every hour. Many women will get hot flushes at night which can lead to disturbed sleep which can result in forgetfulness, irritability and a lack of concentration. Tips for managing these symptoms include:

  • Keeping a battery operated fan with you at all times
  • Wearing layers so that you can remove clothing when a flush starts
  • Using a silk pillowcase or a cool pillow known as a chillow
  • Drinking plenty of water and avoiding caffeine, alcohol and spicy foods
  • Taking regular exercise
Non hormone drugs for hot flushes

Some drugs can help to relieve hot flushes and some women find these helpful. These include:

  • Venlafaxine – a mild anti-depressant
  • Fluoxetine and Paroxetine – other anti-depressant drugs which have shown to be effective in reducing hot flushes
Hormone Replacement Therapy

Although this is an effective treatment for the symptoms of the menopause, the National Institute for Health and Care Excellence (NICE) does not recommend the use of HRT routinely in women following a diagnosis of breast cancer because there is uncertainty about whether HRT increases the risk of breast cancer returning.

Complementary therapies

There is less reliable evidence to show that complementary therapies actually work to reduce the symptoms of the Menopause. However the following may help in some women:

  • Acupuncture – which involves inserting fine needles into the skin at specific points, however it is important to remember not to insert needles in your arm or surrounding tissue if you have had surgery to remove the lymph nodes
  • Aromatherapy – using essential oils to stimulate the sense of smell which is believed by aromatherapists to improve wellbeing.
  • Herbal remedies – such as red clover or black cohosh may be effective in some women in reducing hot flushes but please check first with your oncologist before trying any herbal treatment
Managing stress & anxiety

Many women find that relaxation helps to reduce stress and tension and can also make their menopausal symptoms less severe. These can include yoga, meditation, mindfulness training and cognitive behavioural therapy.

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