Menopause After Breast Cancer: What Survivors Need to Know
Updated: 5 days ago
After breast cancer treatment, menopause can feel like one more thing you didn't exactly get a choice about. And one of the questions I hear most often is, "Can I do anything to relieve all of these unwanted symptoms?"
It is such a reasonable question.
Breast cancer treatment can bring menopause on suddenly, often years earlier than you expected. The symptoms can be intense, and they arrive at a time when you're already dealing with the physical and emotional aftermath of cancer treatment. You may be told that hormone therapy isn't an option and left with the impression that there isn't much else to do.
The answer isn't always simple, especially when it comes to systemic hormone therapy, but there are many ways to treat menopausal symptoms after breast cancer. The right approach depends on your cancer history, your current treatment, the symptoms that are actually bothering you, and what matters most to you.
How Breast Cancer Treatment Changes Menopause
Menopause after breast cancer can arrive all at once instead of through the gradual transition you may have expected. Exactly what happens depends on the treatment you had.
Chemotherapy can impair ovarian function so the ovaries make less estrogen. Sometimes that is temporary and periods come back. Sometimes it is permanent. Surgery to remove both ovaries causes an immediate drop in estrogen, so there is no transition at all. Ovarian suppression uses medication to shut down the ovaries' estrogen production on purpose. That's an important part of treatment for many women with hormone receptor-positive breast cancer because lowering estrogen can lower the risk of recurrence.
Endocrine therapy works differently. Tamoxifen doesn't stop the ovaries. It blocks estrogen signaling in breast cancer cells while acting like a weak estrogen in some other tissues. Hot flashes are among its most common side effects. Aromatase inhibitors block the enzyme that makes estrogen in fat and other tissues outside the ovaries. After menopause, that is enough to lower estrogen substantially. Before menopause, the ovaries are still the main source of estrogen, so an aromatase inhibitor is used with ovarian suppression when ovarian function is active.
All of this can change how menopause feels.
You may have hot flashes and night sweats, disrupted sleep, vaginal and urinary symptoms, sexual concerns, joint and muscle symptoms, fatigue, or changes in mood and concentration. And it isn't always possible to separate what is coming from menopause from what is coming from cancer treatment, stress, poor sleep, or something else. If you're taking endocrine therapy, some of these symptoms can continue for years.
You don't have to simply endure them.
Start With the Symptoms That Are Actually Bothering You
No single menopause treatment has to solve everything.
Maybe hot flashes are waking you up several times a night. Maybe vaginal dryness is affecting your sex life. Maybe you're exhausted because you aren't sleeping, or your joints hurt every morning. Maybe all of those things are happening at once.
The first step is to figure out what's affecting your quality of life and then choose treatments that fit those particular problems.
Effective nonhormonal treatments exist for many of the problems that show up during menopause, and several of them are compatible with breast cancer treatment.
Hot Flashes and Night Sweats After Breast Cancer
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