Breast cancer treatments can cause a rapid decline in sex hormone levels, which can trigger early menopause. This is called medical or surgical menopause, or induced menopause.
On average, menopause naturally starts around age 51. But medical menopause can happen earlier in your 20s, 30s, or early 40s.
For people with breast cancer, menopause symptoms last longer and are more severe than for those without breast cancer who enter menopause.
But if you have breast cancer, you shouldn’t take hormone replacement therapy (HRT), which is often prescribed to alleviate menopause symptoms. The hormones in HRT can cause breast cancer to spread or grow.
Instead, the following lifestyle changes and medications can help lessen the severity of menopause symptoms once they start.
The symptoms of menopause often vary widely. The most common symptoms include:
- hot flashes
- night sweats
- irregular or missed periods
- vaginal dryness
- weight gain
- sleep problems, such as insomnia
- mood changes, such as depression or anxiety symptoms
- memory problems or difficulty concentrating
- hair thinning and loss
- unwanted hair growth
- dry skin
- reduced libido
- urinary tract infections (UTIs)
- bone loss (osteoporosis)
You shouldn’t take HRT if you have breast cancer. Not only can HRT
There are many types of medications available to treat menopause symptoms depending on your needs.
- topical minoxidil for hair thinning and loss
- eflornithine, a topical cream for unwanted hair growth
- antidepressants, such as paroxetine (Paxil), for anxiety and depression (low doses of these medications can also treat hot flashes)
- gabapentin (Neurontin), a nerve medication used off-label as another nonhormonal option for hot flashes
- nonhormonal vaginal moisturizers and lubricants, such as ospemifene, for vaginal dryness and painful intercourse
- sleep medications for insomnia
- antibiotics for UTIs
- denosumab (Prolia), teriparatide (Forteo), raloxifene, or calcitonin for osteoporosis
Making a few changes to your day-to-day activities can help reduce side effects and improve your overall quality of life.
Exercise can help with fatigue and improve your mood. It can also help you manage your weight.
If you’re undergoing treatment for breast cancer, you’ll want to start slow and then build up the intensity and duration of your workouts over time.
Eventually, you’ll want to aim for at least 150 minutes of moderate aerobic activity, or 75 minutes of vigorous aerobic activity, every week, according to the
Pelvic floor exercises
On top of regular exercise, it’s important to keep your pelvic floor strong. Loss of estrogen can weaken the pelvic floor and lead to issues with bladder and bowel control.
The most well-known type of pelvic floor exercise is Kegels. Activities such as yoga and other exercises can also help strengthen your pelvic floor.
Avoid hot flash triggers
You may notice certain activities trigger a hot flash. Taking note of your triggers can help you avoid them. Common hot flash triggers often include:
- spicy foods
- tight clothing
- exercising right before bedtime
- hot beverages
- smoking or exposure to secondhand smoke
- warm rooms
- hot tubs and saunas
Smoking tends to increase the severity and duration of menopause symptoms. If you smoke, quitting might help reduce your symptoms.
It can be difficult to quit and may take a few attempts, but it’s worth it in the long run.
Aside from prescription medications and making changes to your daily life, there are a few other options to try to help lessen symptoms of menopause.
A good moisturizer can help keep your skin from getting too dry. Applying a moisturizer after you bathe can help lock in moisture.
To reduce bone loss, you can take calcium, vitamin D, and magnesium supplements.
Vitamin E and omega-3 fatty acids may also help treat the vasomotor symptoms of menopause, such as hot flashes and night sweats.
Talk with your doctor about these supplements and others for your individual needs.
Vaginal dilator therapy
During menopause, the vagina can narrow due to low estrogen. This can lead to pain and anxiety around intercourse.
Vaginal dilators are devices that are used to stretch the muscles of the vagina so that sex is less painful.
The device usually consists of a plastic or silicone rod or cylinder with a rounded end that is inserted into the vagina. Vaginal dilators can also help relax or strengthen the pelvic floor muscles.
Talk with a psychologist, psychiatrist, or other mental health professional about depression, anxiety, or stress. These professionals may use an approach known as cognitive behavioral therapy. They can also prescribe medications to help improve your mood.
People who experience early menopause as a side effect of their breast cancer treatment often have more severe symptoms that last longer than those who enter menopause naturally.
Though HRT isn’t considered safe for people with breast cancer, there are other medications available to help manage symptoms of menopause.
Lifestyle changes and avoiding triggers can also help. If you haven’t yet experienced menopause and were recently diagnosed with breast cancer, be sure to discuss how to manage medical menopause with your doctor.