How to Cope with Menopause After Breast Cancer

Menopause is a part of any woman's aging process. It usually happens over the age of 50 but varies.  Something that can make it occur much earlier is breast cancer treatments that bring the process on early and somewhat suddenly. This experience is referred to as medical, or surgical induced menopause. While menopause is often difficult for women at any age, it can be particularly difficult for those who either have or have had breast cancer in their lives. Symptoms are often intensified, some helpful treatments can't be taken, and more.

However, there are some helpful tips to keep in mind while going through menopause after breast cancer.

What causes medical or surgical induced menopause?

It has been shown that certain chemotherapies, and some hormonal therapies, have the ability to decrease the rate at which the ovaries produce eggs. In some cases, they can stop the functioning altogether. It is sometimes possible that medical menopause is only temporary, and your ovaries will begin to function as they had before after you cease that particular treatment and you'll begin to have your period again. However, this is not always the case and often the effects may be permanent.

In some cases, removing the ovaries may be necessary in breast cancer treatment. Of course, this will cause immediate permanent menopause, and is a type of surgical menopause.

How does breast cancer affect natural menopause?

Certain therapies that are used to treat breast cancer are not actually causes of menopause itself, but simply symptoms that are often attributed to menopause, like hot flashes. This is especially common if you are "premenopausal" when you receive your diagnosis, or if your body is already going through menopause naturally. However, certain breast cancer treatments are notorious for making menopause symptoms significantly worse, unfortunately.

Often people will take hormone replacement therapy when they are experiencing natural menopause symptoms that are particularly severe, and sometimes debilitating. However, HRT is advised against in women who have either been diagnosed with breast cancer or are known to be at a high risk. Because these women stop taking HRT when they find they have breast cancer or a high risk of it, due to the link between HRT and risk of breast cancer, they will begin to experience what some refer to as cold turkey menopause. This is the withdraw from the medicine that intensifies the symptoms of menopause.

Cold turkey menopause, along with medical and surgical menopause, lower hormone levels drastically due to the change they initiate within the body. This change naturally occurs over a longer period of time, allowing the body to adjust, but what sometimes occurs over a period of years is condensed into weeks or sometimes only days.

How do young people experience menopause?

If women in their 20s, 30s, or early 40s experience menopause due to their breast cancer treatment, it can come as a shock to their systems even more than those who are older. These women often believed they had decades before they would experience the change, which means that they are not as mentally prepared for the experience.

For those who need to have their ovaries removed at a young age, significant reduction of hormones is experienced, resulting in some of the strongest menopausal symptoms.

Such early menopause can also begin to cause other health problems as you spend more time relying on your body without the support of estrogen. One of the major problems is bone loss.

How common are these experiences?

Studies have depicted that most patients who have breast cancer will experience symptoms either of menopause or clinical manifestations of estrogen deficiency upon completion of their therapy. It is estimated that, within this population, those who experience estrogen-deficiency symptoms is around 79 percent to 95 percent.

This is obviously a very high number. However, keep in mind that these symptoms are not always found to be permanent.

Often, symptoms will include vulvovaginal atrophy, sleep disorders, vasomotor symptoms, mood changes, cardiovascular disease, depressive symptoms, osteoporosis and osteopenia. However, because the normal treatment of hormone replacement therapy is not the route suggested for women with breast cancer, these symptoms can often be difficult to handle.

Solutions

Although the abrupt jump into menopause, or the harsher symptoms, can be difficult, there are ways to cope with the situation that will act as a significant aid. The inability for those who have either had or have breast cancer to use hormone replacement therapy (or the hormone-mimicker drug tibolone) is a hard hit, but that does not mean there are no other ways to improve experiences with symptoms.

The Journal of Clinical Endocrinology & Metabolism has published a guide that is able to help those who have or have had breast cancer to manage their menopausal signs and symptoms.

Richard J. Stanten, MD stated, "following breast cancer, women should generally not be treated with menopausal hormone therapy but should instead focus on lifestyle modifications such as smoking cessation, weight loss, and regular physical activity. Pharmacologic agents are also available to treat women with severe symptom. The most important thing to remember is that therapy must be individualized based on each woman's needs and goals."

Lifestyle changes are considerable in assisting in relieving menopause symptoms. Exercising properly and eating well are crucial to general health, but will also assist in relieving symptoms. Making sure that you have enough vitamin D and calcium in your diet to attain and maintain proper levels is crucial.

If you smoke, try to quit or significantly cut back. Limiting or entirely avoiding alcohol is also shown to have significant benefits. Cutting out bad habits such as these has numerous health benefits, cuts down your risk of other diseases, and can greatly improve your experience of symptoms.

With women who find themselves experiencing moderate to severe symptoms of menopause with breast cancer, mind-brain-behavior, or nonhormone pharmacologic therapy, has been shown to aid some of the pains associated with menopause.

Selective serotonin/noradrenaline reuptake inhibitors and gabapentinoid agents are able to visibly improve vasomotor symptoms and in turn even lift the quality of life for many patients. There are many nonhormonal therapeutics that are available for osteoporosis as well.

Unfortunately, the treatment of VVA needs to be further assessed by doctors and there are many breakthroughs to be made in the future. Vaginal laser therapy is currently being used for it, but many contest its efficacy, leading to much doubt surrounding the treatment.

Finally, reach out to friends or support groups to emotionally uplift you. Sometimes emotional pain at the shock of early or abrupt menopause can intensify the physical pain, so make sure that you are talking it through with someone you trust.

References

http://www.breastcancer.org/tips/menopausal

https://www.medscape.com/viewarticle/884647#vp_3