Menopause is the natural transition your body makes when your periods stop. For most people who have periods, this process happens during your 40s and early 50s.

Chemotherapy drugs can cause symptoms of menopause to happen much earlier in life. This is referred to as chemo-induced menopause.

Chemo-induced menopause, also known as chemopause, can be hard to wrap your head around. Knowing what to expect and why it happens can help.

This article takes a deeper look at how chemotherapy affects your menstrual cycle.

Menopause refers to the time in your life when your ovaries stop producing the hormones estrogen and progesterone. During this time, your ovaries also become smaller in size. Your menstrual cycle becomes irregular due to these changes and eventually stops happening completely.

The same hormone shifts that cause your periods to stop can cause other temporary symptoms too, including:

  • hot flashes
  • irritability
  • insomnia
  • decreased sex drive

Menopause is seen as complete when you haven’t had a period for a full year. The average age for menopause is 51, according to 2022 research.

When you’re undergoing cancer treatment, menopause can start earlier. According to 2011 research, chemopause can also cause vasomotor (VMS) symptoms like hot flashes and night sweats, just like menopause. VMS symptoms are symptoms caused by the narrowing and widening of your blood vessels.

Chemo-induced menopause symptoms, however, can feel more severe. During a 2020 study, women with chemo-induced menopause experienced more hot flashes and fatigue than women whose menopause had occurred without chemotherapy.

Healthcare professionals often use chemotherapy drugs to treat cancer. These drugs work by killing cancer cells in your body, according to the National Cancer Institute.

Chemo targets cells that grow and divide quickly. This means that it also kills healthy cells, like the ones your body uses to grow hair. This side effect of chemo also affects reproductive organs, including your ovaries, along with the hormone levels in your body.

Estrogen and progesterone levels in your body may fall out of balance due to the way chemo affects your endocrine system. Cell damage and hormonal imbalances caused by chemo can trigger menopausal symptoms and may even cause your periods to stop.

If you’re over age 40 when you start chemotherapy, your hormone levels may already be lowering. If this is the case, chemotherapy simply speeds up the menopause process your body has already begun.

Symptoms of chemopause are very similar to menopause. These symptoms may feel more severe since the drop in your hormones occurs in a very short span of time rather than gradually.

Symptoms and signs of menopause may include:

  • changes in your menstrual cycle
  • irritability, depression, and mood shifts
  • vaginal dryness and pain during sex
  • hair loss or a change in your hair’s texture
  • urinary tract infections
  • decreased sex drive
  • weight gain

Chemo-induced menopause can be temporary or permanent. There’s no way to know before you start your treatment how the drugs will affect your hormone levels. An oncologist may be able to give you an idea based on:

  • your age
  • the type and length of your chemo treatment
  • other therapies and treatments you have been on
  • your hormone levels prior to treatment
  • strategies to preserve ovarian function

Regular menstruation may resume anywhere from several months to 2 years after your chemotherapy is finished.

A 2015 study looked at 280 people with breast cancer who received a diagnosis before age 45. Of them, 255 people experienced chemo-induced menopause, where their period stopped for more than 3 months after the chemotherapy ended. However, 170 people started menstruating again at some point. On average, it took 8 months for a period to return. Of the participants who entered menopause, 84 did not resume their period at all.

In this particular study, age seemed the biggest predictor of whether the menstrual cycle would return post-chemo.

When your period returns, it may be different than it was before chemo. Most of what we know about post-chemo periods is anecdotal, and more research is needed to understand if and how cycles change when they return.

It does appear that people who have chemotherapy and resume menstruating may experience menopause years earlier than others.

Preserving fertility before chemo-induced menopause

If you want to have children after chemo, talk with an oncologist prior to your treatment about a fertility plan that’s right for you.

Some people choose to take medications that pause their period before chemotherapy starts. The goal of this is to protect the ovaries and minimize the damage to your eggs. Other people opt to freeze their eggs before they begin cancer treatment.

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Managing chemopause is similar to managing menopause, with some important differences. Certain hormone replacement medications and mood stabilizers may not be recommended during chemotherapy and remission from cancer.

Your doctor will have recommendations about how to treat symptoms of menopause while you undergo and complete your cancer treatment.

Lifestyle modifications

If your symptoms are mild to moderate, you may be able to treat them by making some lifestyle modifications. This can include avoiding triggers like alcohol and spicy food, using a fan in your bedroom, and lowering the temperature in your home to reduce hot flashes.

Maintaining a moderate weight and regularly taking part in weight-bearing and aerobic exercise can help you manage your mental and physical health.

Nutritional supplements

Supplements may help offset the way that chemo-induced menopause disrupts your hormones.

You may want to try a low dose of vitamin E to see if it helps reduce any night sweats and hot flashes. Vitamin D, along with a calcium supplement, can help protect your bones from osteoporosis, which is more common after menopause.

Anecdotally, some people claim black cohosh and dong quai can reduce symptoms, but there’s currently little evidence to show that they are effective.

It’s worth noting that there are a number of documented interactions between dietary supplements and chemotherapy medications, according to the ASCO Post. Be sure to speak with a doctor about any supplements you’re considering before taking them.

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Complementary therapies

There are also integrative health practices that may help to reduce your symptoms. Acupuncture is popular for the treatment of hot flashes and insomnia. Yoga can also help improve your quality of life whether you’re experiencing chemopause or menopause, according to a 2014 study.

Hormone replacement

Some people opt for hormone replacement therapy to try to manage the effects of menopause. People who have had any kind of estrogen-sensitive cancer are often advised not to take these kinds of drugs, as they may increase the chances of your cancer coming back.

Other medications

There are also a wide variety of nonhormonal medication choices. An anticonvulsant medication called gabapentin has been used to help treat the symptoms of hot flashes caused by menopause. SSRIs and SNRIs have also been used with success to help with hot flashes as well as irritability, depression, and mood swings.

Chemo-induced menopause is common. It can be temporary, but it’s difficult to predict whether or not your period will come back after your treatment is complete. Some people may also experience more severe menopause symptoms as their bodies adjust to a major hormonal change on top of dealing with the effects of the chemo.

Your oncologist and cancer treatment team will be able to prepare you for the side effects of chemo. You may also want to speak with your doctors about natural therapies and medications to help manage the symptoms of menopause.