Living with cancer is a life-changing experience. Life after cancer can also come with challenges, especially for women experiencing menopause.
Roughly 9 million women are diagnosed with cancer each year, more of whom are surviving the disease after treatment. As a result, more women are also experiencing long-term effects of cancer treatment – including early menopause.
Because cancer is such a focal point for patients, questions about menopause can sometimes feel small or unimportant. It may also not always be clear to know what to expect. Fortunately, discussions around hormonal changes are becoming more commonplace.
“Particularly younger patients really want a good quality of life. It’s not enough to just be cancer-free,” said Sanford Health nurse practitioner Laurie Gromer. “It’s OK to bring those things up and admit that you’re not OK.”
More questions bring about more answers and a better understanding for patients navigating their health journey, as well as for the providers and specialists helping them along the way.
“Our job is to not just focus on the cancer, but also on you and to make your life the best that it can be,” Gromer said.
Are menopause symptoms different with cancer?
When it comes to menopause, the catalog of symptoms is the same regardless of whether someone has received cancer treatment. Hot flashes are among the most common symptoms, occurring in roughly 80% of women.
Other common symptoms for women experiencing menopause can include:
- Mood swings
- Depression
- Anxiety
- Heart palpitations
- Insomnia
- Lack of energy
- Joint pain
- Vaginal dryness
- Burning
- Painful intercourse
- Trouble sleeping
Some symptoms, such as headaches, muscle pain, brain fog and feeling forgetful, could also be confused with side effects of chemotherapy, blurring the lines for patients.
“That’s why we need to talk about it,” Gromer said. “We need to sort through: could this have something to do with your cancer or is it just simply a hormonal shift that we can figure out how to help you with?”
What does menopause look like after cancer treatment?
Although menopause symptoms are generally the same, one variance for cancer patients is that menopause could happen much sooner than it would naturally.
The average age of menopause is around 51 years old, but cancer treatment or ovary removal can bring about symptoms for someone younger. Those symptoms are the same regardless of age, but they may feel more intense for younger patients.
“Surgery, chemotherapy, radiation can all induce menopause in someone whose body was not ready to go through that,” Gromer said. “Therefore, some of these side effects can be a little bit more severe because it wasn’t gradual.”
Women who have received treatment for hormone-sensitive cancers (breast, ovarian, uterine) may also experience menopause symptoms even if they’ve already gone through menopause.
These types of cancers feed on estrogen, and while ovaries stop making estrogen during menopause, the body still produces it in other tissues such as fat, skin, muscles and adrenal glands. To cut off that food supply, doctors may prescribe medication to stop estrogen production, and that shutdown can induce menopause symptoms.
“These benefits that this lingering estrogen was giving you, we’ve now caused some trouble with,” Gromer said. “They might be 75 years old and getting hot flashes again. It’s confusing because women think, ‘I already did this. Why am I having to go through this again?’”
What are management strategies for menopause after cancer?
There are options for managing menopause symptoms after cancer, ranging from lifestyle changes to medications to supplements.
Limiting certain foods and drinks, like alcohol, chocolate and caffeine, can reduce hot flashes, while some women find that smaller meals and losing weight helps with symptoms.
“A healthy diet can make a big difference,” Gromer said. “We also have additional layers of support with our dietitians, integrative therapists, exercise specialists, mental health providers, etc., which are accessible through a simple referral.”
Nonhormonal medications can bring relief for symptoms such as hot flashes, night sweats and vaginal dryness. Prescription antidepressants can help with changes in mood, and sometimes other symptoms such as hot flashes.
Female cancer patients who are on estrogen-limiting medications for hormone-sensitive cancers are at a much higher risk for osteoporosis. Therefore, their doctor may suggest calcium or vitamin D supplements to support bone strength.
Menopausal hormone therapy (MHT) could be an option for patients whose cancer is not hormonally driven. Vaginal estrogen is also a safe option for any woman for vaginal and urinary symptoms of menopause. However, patients treated for hormonally driven cancers cannot receive an estrogen pill or patch.
Gromer encourages patients to discuss any medications or supplements with their provider as options will depend on each patient’s unique case, symptoms and medical history.
“Be open and honest about any supplements or anything that you’re considering taking because we would want to work together on that,” she said.
How cancer survivors can work with their care team through menopause
Prioritizing your health doesn’t have to be a solo journey. It also doesn’t require a neat and tidy timeline. You can schedule an appointment any time to discuss any symptoms you’re experiencing.
“These are huge quality of life factors for these women because they’ve got a lot of other stressors going on,” Gromer said. “A lot of times they’re raising kids, they’re married, they’re working. If you go through menopause earlier, you’ve got a whole other dynamic than you do if you’re getting a little bit older. There are a lot of things going on in their life, plus the stress of just having been through cancer.”
Gromer reminds patients that most menopausal symptoms – early or not – are not a permanent condition and the team at Sanford Health is here to help.
“Your body figures it out and resets,” Gromer said. “Regardless of the age, we can help get you through this.”
Schedule a wellness visit online at My Sanford Chart and find menopause care at Sanford Health.
Learn more
- Survivorship: A critical part of the cancer journey
- Perimenopause: Beginning the transition into menopause
- Is there a link between menopause and genetics?
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Posted In Cancer, Cancer Treatments, Menopause Care, Women's
