Life After Cancer: Menopause After Treatment 

What is menopause? 

Menopause is when a person stops having menstrual periods. It's a natural process that happens slowly as a person ages.

Menopause tends to start between ages 45 and 55. Then, over time, the ovaries make less estrogen and progesterone. This can cause symptoms such as:

• Sudden feelings of warmth (hot flashes) many times a day

• Sweating that may seem worse at night

• Weight changes

• Tiredness

• Trouble going to sleep or staying asleep (insomnia)

• Memory and mood changes

• Low sex drive

• Dry skin

• Dryness and thinning of the vaginal tissues. This can cause pain with sex.

• Needing to pee (urinate) often

• Bone thinning (osteoporosis)

• Bladder control problems   

Why menopause can happen after cancer treatment 

Menopause can happen if the ovaries are affected by cancer treatments. These include:

• Surgery to remove the ovaries

• Radiation therapy to the pelvis or lower belly. This can damage the ovaries.

• Hormone therapy such as tamoxifen. This can block how estrogen works and cause menopause symptoms.

• Chemotherapy. This can cause the ovaries to shut down and cause menopause symptoms. Symptoms may last for months or years after treatment.

In many cases, these hormone changes happen quickly. This can make menopause symptoms worse.

Menopause symptoms may go away in younger people after they've been off treatment for a while. Normal periods may even start again. But menopause is more likely to be lasting (permanent) in older people. And removing the ovaries leads to permanent menopause in people of any age. 

Talk with your healthcare provider about your cancer treatment. Ask if it might cause menopause. 

Managing your symptoms 

Tell your healthcare provider about any changes you notice. They can talk with you about how to manage symptoms. Try these tips:

• Hot flashes. Wear layers of clothes that are easy to remove. Use a fan. Wear all-cotton clothing. Keep cold water nearby. Keep track of things that trigger your hot flashes. Try to stay away from the triggers. This may include spicy food, caffeine, stress, or alcohol.

• Night sweats. Use all-cotton sheets and blankets you can remove easily. Keep a glass of water and a fan by your bed. Change the thermostat as needed.

• Vagina pain during sex. Use a water-based vaginal lubricant before and during sex. Talk with your partner about how you are feeling. Use positions that don't hurt. Tell your healthcare provider about your symptoms. They may have advice to help manage and prevent pain.

• Vaginal dryness and itching. Use a vaginal moisturizer a few times a week.

• Mood swings. Try relaxation therapy or acupuncture. Limit alcohol. Get enough sleep. Talk with a cognitive behavioral therapist. They can help you manage mood changes. Ask your provider about dietary supplements and prescription medicines that may help.

• Memory problems. Get enough sleep and eat well. Stay mentally active by taking a class, learning a new skill, or doing word puzzles. Staying socially active also helps.

• Low sex drive. Talk with your partner about other ways to be intimate when you’re not feeling your best.

• Insomnia. Ask your healthcare provider about prescription medicines that may help you get better sleep. Get regular exercise. Limit your screen time before bed.

• Bladder changes. Limit caffeine. Wear pads to absorb leakage. Ask your provider about exercises that can help.

Staying healthy after menopause 

Menopause can cause some problems with a person’s health. These can include:

• Bone loss (osteoporosis). Bones can start to thin after menopause. This is due to lower levels of estrogen. This raises your risk for bone breaks.

• Weight gain. It’s easier to gain weight after menopause. This is because of the changes in hormone levels.

• Heart disease. Estrogen protects against heart attacks and strokes. Less estrogen is made after menopause. This leads to a higher risk for heart disease. This includes problems such as high blood pressure and heart attack. 

You can help yourself stay healthy by:

• Eating a healthy diet. Healthy foods can help you manage your weight. They can lower your risk for heart disease. They may boost your mood. Talk to your healthcare provider or a dietitian. They can help you understand your nutritional needs and what to eat.

• Getting physical activity. Get plenty of weight-bearing activity. This includes walking or running. This kind of exercise can help keep bones stronger. It can help prevent bone breaks. Exercise can help you control your weight. It may improve mood and sleep.

• Taking supplements. Ask your healthcare provider if you should take calcium and vitamin D supplements. These can help prevent bone loss.

• Not smoking. Smoking raises your risk for heart disease and many other problems. And it’s not good for bone health. Ask your healthcare provider about resources to help you quit if you smoke.

• Getting regular tests and exams. Get bone density tests, colon cancer screenings, pelvic exams, HPV/Pap tests, and mammograms as often as your provider advises. 

About hormone therapy 

Hormone therapy helps treat menopause symptoms. It uses estrogen, progesterone, or both. It comes in pills, creams, gels, rings, caps, sprays, and patches. But after cancer you may not be able to use hormone therapy. It may raise your risk of cancer coming back. This depends on the type of cancer you had. Using non-prescription bioidentical hormones from plant sources may raise your risk.

Talk with your healthcare provider about the risks and benefits before starting any kind of hormone therapy. They can tell you if it’s safe for you. 

Working with your healthcare provider

As you move on to life after cancer, work with your gynecologist to help you manage menopause symptoms. Make sure they know about your cancer history. Talk about your symptoms. You can work together to help you feel better. You may be given medicines that can help if your symptoms are very bad and affect your daily life. 

Some herbs and supplements may help reduce menopause symptoms. But talk with your healthcare provider before taking any of these.