Cancer Survivorship and Early Menopause-- What You Need to Know

Menopause can feel like a daunting hill to climb and crest even when it happens naturally; many women feel concern over how their lives may change once menopause hits.

When the possibility of early-onset menopause brought on by chemotherapy is mentioned to young women with cancer, it can feel like a shock. Cancer survivors often feel like they have enough on their plate before something like this is dropped onto it. "Chemopause," as it's known within the cancer community, is something that few women know is a possibility until they're informed about the condition by their treatment teams. Sometimes this change is temporary and sometimes it's permanent, but one thing is for certain-- it's a big change. Here is some information that can help you understand what you may expect as a cancer survivor in early menopause.  

What Cancer Treatments Can Cause Menopause?

Treatment-induced menopause can be brought on by various cancer treatment options including:

  • Chemotherapy
  • Radiation Therapy
  • Surgical removal of the ovaries
  • Hormone therapy

Out of these, chemotherapy is seen as the most common cause of early-onset menopause (hence the term "chemopause"). Certain medications utilized in chemotherapy treatment tend to cause damage to the ovaries which, in turn, leads to menopause.

When the ovaries are damaged, the production of female hormones like estrogen is drastically decreased-- this is what causes troubles with menopause, fertility, and other reproductive factors. Without hormones like estrogen circulating to regulate a woman's menstrual cycle, her body will eventually cease releasing eggs from her ovaries and her menstrual cycle will come to a standstill.

This sometimes shocking experience with early menopause can last anywhere from the length of a patient's treatment to the rest of their lives; and unfortunately, the duration of the experience is tough to predict. It can be tough for women to hear that there's no answer to when their fertility may straighten itself out, but it's the reality of treatment and it's something that women should consider and be prepared for.

Several factors can and do play into the likelihood of a woman's menstrual cycle returning, but refraining from betting on any particular outcome is crucial to keeping a cool head during the process. Factors such as age before the start of treatment and exactly which drugs are used in that treatment can and do influence the permanence of "chemopause." Those over forty, for example, may take some comfort in the fact that they're statistically less likely to start menstruating again than their younger peers.

The Symptoms of Cancer Treatment-Induced Menopause

Cancer survivorship can present daily battles; and, unfortunately, treatment-induced menopause can present even more. Premature menopause that's spurred by cancer treatments such as chemotherapy can present symptoms that are more severe than if menopause had been reached naturally. This is due to the abrupt nature of treatment-induced menopause. Many of the symptoms are identical to the classic ones that are featured in textbooks and pamphlets on the subject:

  • Hot flashes
    • Sensations of heat
    • Redness and/or flushing
    • Spontaneous, sometimes excessive sweating
  • Mood changes
    • Mood swings
    • Depression
    • Irritability
  • Sleep issues
  • Vaginal dryness
  • Urinary problems
    • Burning pain while urinating
    • Leaking when sneezing, coughing, etc.
  • Concentration and memory issues
  • Lower libido and diminished sexual response
  • Weight gain

It can be difficult to manage so many symptoms when you've already experienced cancer survivorship and are dealing with other side effects of cancer treatment. While emotional issues and depression are common factors even in cases of typical menopause, these effects may be even more pronounced in women who are struggling with the unique emotional battle of early-onset menopause.

When to Talk to Your Team

You should always speak to your doctor or oncology team when you're experiencing health and treatment concerns. Before treatment even occurs, you should be speaking with your healthcare team about fertility options, concerns, and getting a plan into place to manage any symptoms you may experience should you be impacted by early menopause.

During and after treatment, maintaining an open line of communication with your cancer care team can make the difference between living in fear and having hope for the future. Being honest about your emotions and your physical state may lead you down symptom management or reversal methods that wouldn't have been considered if you'd kept quiet.

Managing Cancer Treatment-Induced Menopause

Hormone Replacement Therapy (HRT)

Hormone replacement therapy that utilizes estrogens and progesterone can do wonders in easing the effects of treatment-induced menopause. Because HRT is so complex, this is a topic best left to direct discussion with a medical oncologist. Factors like the type of cancer being treated, age, and the exact hormones to be used in HRT treatment all play a part in whether or not the decision to go through with the therapy is a good one.

Antidepressants

Antidepressants are a non-hormonal treatment option that some women see great benefit from; one clinical trial indicated that women who took antidepressants every day experienced a 61% reduction in the frequency of their hot flashes. Antidepressants also have the potential to offer some relief from the emotional highs and lows that can come with menopause.

Lifestyle Changes

There are also other methods of managing menopause that are a little less direct; these include:

  • Limiting spicy foods, caffeine, and alcohol to help reduce the occurrences of hot flashes
  • Using water-soluble lubricants to counteract vaginal dryness
  • Engaging in regular gentle exercise in order to relieve emotional symptoms
  • Staying comfortable in light, breathable clothing in order to reduce physical discomfort from hot flashes
  • Keeping well hydrated in order to avoid bladder and vaginal infections from dryness and hormonal changes

If you or a loved one is experiencing cancer treatment-induced menopause, or if you want to express concerns about the possibility of it, speak to your Compass Oncology cancer care providers. Being forthcoming about your mindset surrounding potential or past treatment plans can help your healthcare team gain a better understanding of the best way to offer you relief and steer you towards health.