Menopause and Cancer - Tips for Coping

Cancer and its treatments will undoubtedly cause many changes in your life. One change you might not have anticipated at the outset is going through the menopause early.

If you have a gynaecological cancer (womb, ovarian, cervical, vaginal or vulval), certain types of chemotherapy, radiotherapy or surgery may bring on symptoms of menopause - sometimes quite suddenly. There are also some types of drugs used for the treatment of breast cancer that block the action of hormones working and bring on menopausal symptoms while you are taking the treatment.

An early menopause can be distressing and make you feel overwhelmed, isolated or confused about the changes happening to your body.

The good news is - for most people - there are very effective ways to manage your menopause and help you live well after cancer. This is why it is so important to find out about early menopause, ask for support when you need it and get the right help as soon as possible.

Here are 10 tips for staying ahead of the menopause:

Learn about what might happen and why

If you know your cancer treatment might cause an early menopause, it is worth taking the time to find out how it might affect you and what the treatments are.

‘Forewarned is forearmed’, as the saying goes, so read up about early menopause. Check out Menopause & Cancer as a starter for ten. Macmillan has some useful info too and The British Menopause Society is also helpful. ‘Surgical menopause’, ‘premature ovarian insufficiency’ or ‘POI’ can also be useful search terms. Getting reliable information is key so look for sites associated with trusted organisations that have been around for a while and have a proven track record of reliability and integrity.

Be on the lookout for menopause symptoms

The severity of symptoms can vary tremendously; they may come on very suddenly after surgery and be noticeable straight away, while others may begin experiencing symptoms after chemotherapy asa gradual change. You might not initially realise these symptoms are related to an early menopause. Using a symptom checklist can help you keep track of what's happening to your body.

Common symptoms of the menopause include:

• Changes to your periods (in frequency or flow, or them stopping altogether)

• hot flushes

• night sweats  

• mood changes (especially if you’ve had PMS in the past)  

• fatigue and poor sleep

• difficulty concentrating

• loss of interest in sex  

• joint pains and muscle aches  

• dry or itchy skin

• headaches (or worsening migraines if you already suffer with them)

• needing to wee more often or having leaks of urine when you cough or sneeze

• urine infections or thrush

• dryness and soreness in and around your vagina.

Symptoms can really vary from person to person. Some people experience very few symptoms whereas others experience many symptoms that can have a very negative effect on the quality of their lives.

Keep a note of your symptoms

A useful idea is to start logging symptoms when they happen. There are several ways you can do this. Keep a diary, use a period tracker app, or fill in a form called the ‘Greene Climacteric Scale’ and take that with you to your doctor.

Keeping track of your symptoms will also be really useful if you start any treatments for the menopause - to see if it’s working for you.

See a doctor that specialises in the menopause

You may feel as though you see enough medical professionals already and the thought of another set of appointments might put you off this idea. Getting the right treatments for your menopausal symptoms is essential to feeling the best you can. You can be referred to a specialist by your GP or CNS. You can find a specialist near you through The British Menopause Society.

The main hormones your body will not be producing in adequate levels are estrogen and progestogen. Possible treatment can involve replacing these with ‘body identical’ versions in the form of HRT (hormone replacement therapy). Making sure you are on the right type and dose of HRT can sometimes need a specialist.

You may also benefit from taking testosterone, particularly if you’re struggling with low energy, mental fatigue and a lack of interest in sex.

There are alternatives to HRT for those who can't take HRT due to the type of cancer they have had. These can be discussed by a doctor who specialises in the menopause.

Be open with family and friends and use them for support

If treatments for your cancer have finished and things have calmed down on that front, family and friends may think you’re through the worst and attention can move on to other things. You, meanwhile, may be just at the start of another challenge. Some people find coping with their menopausal symptoms harder than going through the cancer treatments.

Sometimes you can feel as if you’re going mad for example if your mood changes suddenly or you start forgetting simple things. Don’t worry, it’s usually just your hormones and it’s so common for those going through the menopause to feel exactly like that.

Get treatment for menopausal symptoms, sooner rather than later

Hopefully, if your doctor knows your surgery, chemo, or radiotherapy is likely to cause an early menopause, they will already talk to you about replacing the lost hormones you might need and will mention HRT (hormone replacement therapy) early on in the process.

It’s not a great idea to resist or put off taking HRT if it has been suggested to you by your doctor. Symptoms can come on very suddenly and the earlier HRT is started the better you will feel.

If you had a hormone-sensitive (hormone-dependent) type of breast or uterine cancer you may not be able to take HRT but check this out thoroughly with a specialist and see what else you can do to improve symptoms.

Persevere with getting the right treatment and stay on it for as long as you feel it’s needed

HRT will not normally be recommended until you are at the age of a natural menopause, which is 51 years. It is understandable that you might not be keen to be on medication for so many years if you are still in your 20’s or 30’s. Many women continue to take HRT forever.

What the replacement hormones are doing is – as well as keeping away symptoms that can impact negatively on your life – they are protecting your health and preventing long-term consequences of a lack of estrogen and progestogen. Without HRT, you will be at risk of your bones becoming weak and developing osteoporosis; you are also at risk of heart disease.

Look after yourself

It is important to try and have a lifestyle that will help, rather than hinder, your menopause.

Basic tips include:

• Eat a healthy, balanced diet rich in vitamins and minerals, especially calcium

• Exercise regularly, if you are able

• Limit alcohol and cigarettes - alcohol can interrupt sleep and exacerbate hot flushes. If you smoke, try to cut down with the aim of quitting altogether

• Get enough vitamin D to help protect your bones and lift your mood - you may want to take it as a supplement

• Relax - where possible take time out for yourself and do something you enjoy that lifts your mood

Look after your relationships

Even the closest bonds can be tested to their limits during menopause. Hormones can wreak havoc, leaving us angry one minute and tearful the next. Talking about how you’re feeling is the single most effective way to getting through it with the support of those you love.

There may be times when you don’t feel like talking or being around others, so don’t be afraid to make that space for yourself and explain why.

Be proactive about how it affects you at work

You may have already returned to work when the menopausal symptoms start having an unwanted effect on you. Try and talk to your line manager and ask for a meeting to discuss your health and implications for work.

There are loads of things you can do to combat menopausal symptoms at work from looking at the setup of your work environment, ways to plan your day, taking 3-minute stress buster time-outs, using memory aids and so on.

‍