Early Menopause as a Cancer Survivor

Even when it happens naturally, menopause can be a challenging transition, causing many women to wonder how much “the change” will affect their lives. 

As a young woman with cancer, it can certainly be a shock to hear that your chemotherapy treatment could trigger early-onset menopause. There is already so much to deal with, and now this. Unfortunately, “chemopause," as it's known within the cancer community, is rarely common knowledge. In fact, most women don’t learn about it until they begin to discuss their cancer treatment options with their oncologist. While this change is temporary for some women, it can be permanent for others. Regardless, it’s a big change that can be hard to adjust to. That’s why we’ve compiled some important information that can help you understand more about what you could face as a cancer survivor in early menopause.  

Cancer Treatments that Can Cause Menopause

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

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

Out of these, chemotherapy is the primary cause of early-onset menopause (hence the name “chemopause”). This is because of the ovarian damage that can occur after taking certain chemo drugs.   

Once the ovaries are damaged, the production of hormones like estrogen are reduced, resulting in troubles with menopause, fertility, and other reproductive factors. Without the circulation of hormones like estrogen to regulate the menstrual cycle, a woman’s body will eventually stop releasing eggs from her ovaries and her menstrual cycle will come to a standstill. 

Unfortunately, there is no guaranteed way to predict the length of menopause. Depending on the patient, menopause can last anywhere from the length of treatment to the rest of her life. Although this can be difficult to hear, these unknowns about fertility must be talked about so you can prepare accordingly. 

Several factors, such as your age before the start of treatment and which drugs you receive, can and do play into the likelihood of your menstrual cycle returning. Still, it is important to keep a cool head during the process and not bet on any particular outcome. 

Symptoms of Cancer Treatment-Induced Menopause

Menopause, both treatment-induced and classic, share many of the same symptoms. However, due to the abrupt nature of treatment-induced menopause, symptoms of premature menopause can sometimes be more severe than if menopause had been reached naturally. As you go through this change, you might experience: 

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

It’s understandable that you might feel incredibly overwhelmed. And, it’s not surprising that you may find it difficult to manage these symptoms when you've already experienced cancer survivorship and are dealing with other side effects of cancer treatment. Yes, emotional issues and depression are common factors in cases of typical menopause— but women who are struggling with the unique emotional battle of early-onset menopause caused by cancer treatment can experience even more pronounced effects. 

When to Talk to Your Cancer Team

If you experience any health and treatment concerns, we encourage you to reach out to your Rocky Mountain Cancer Centers (RMCC) oncologist or cancer care team. Even before you begin treatment, it’s a good idea to talk with your healthcare team about fertility options, concerns, and creating a plan 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 a big difference as to whether you’ll be hopeful or fearful about the future. The more open and honest you are about your emotions and physical state, the more likely you can find relief through symptom management or reversal methods.

Managing Cancer Treatment-Induced Menopause

Hormone Replacement Therapy (HRT)

The effects of treatment-induced menopause can be eased with hormone replacement therapy that uses estrogens and progesterone. However, because HRT is very complex, it is a topic best discussed with your RMCC oncologist. Factors including the type of cancer being treated, your age, and the exact hormones to be used in HRT treatment can help determine whether or not this type of therapy is the right option for you.  

Antidepressants

Some women may also benefit from a non-hormonal treatment option like antidepressants. One clinical trial even indicated that women who took antidepressants every day experienced fewer and less severe hot flashes. Antidepressants may also provide some women relief from the emotional highs and lows that can come with menopause. 

Lifestyle Changes

Other, less-direct methods can also be used to manage menopause. These include: 

  • Limiting spicy foods, caffeine, and alcohol in order to help reduce occurrences of hot flashes
  • Incorporating regular, gentle exercise into your daily routine in order to relieve emotional symptoms
  • Drinking lots of water in order to avoid bladder and vaginal infections from dryness and hormonal changes
  • Using water-soluble lubricants to counteract vaginal dryness
  • Wearing light, breathable clothing to help reduce physical discomfort from hot flashes

If you or a loved one has concerns about, or is experiencing premature menopause caused by cancer treatment, we encourage you to make an appointment to speak with your RMCC cancer care providers. The more we understand your thoughts, the better we can find ways to offer you relief and steer you towards health.