The menopause is sometimes called the change of life. This is normally the period of time between the early 40s and late 50s when women stop producing sex hormones and their periods become irregular and eventually stop. Women can then no longer become pregnant.
Some cancer treatments can cause an early menopause. These include:
- surgery to remove the ovaries
- radiotherapy to the pelvis
- hormone therapy
An early menopause can also affect your sex life and sexuality.
Effects of early menopause
Early menopause due to cancer treatment can be a shock, and might feel physically and emotionally overwhelming. A sudden menopause can cause more severe symptoms than a natural menopause. The symptoms will pass, but it can take a couple of years.
Hormone replacement therapy (HRT) helps to relieve symptoms for many women who are able to take it. HRT means taking a tablet form of female sex hormones to replace the hormones that your body used to produce naturally.
HRT is not suitable after some types of cancer, such as breast cancer. Talk to your doctor about whether you can take HRT. They can tell you about other ways of reducing menopausal symptoms if HRT is not suitable for you.
The biggest effect of the menopause is that you can no longer become pregnant and have a baby. This is because you no longer produce an egg from your ovaries each month. This loss of fertility can be upsetting even if you have a family or did not intend to have children.
Menopause can also cause:
- vaginal dryness
- hot flushes and sweating
- feeling sad or depression
- loss of confidence and self esteem
- tiredness (fatigue)
- thinning bones
- loss of interest in sex (libido)
Most of these can affect your sex life in some way. Hormone replacement therapy (HRT) will reverse most of these effects for some women. It can also help with the emotional effects of menopause.
Counselling might be effective for emotional or relationship problems, either on your own or as a couple. Or it may just take some time and the support of your partner, friends and family to rebuild your confidence and positive feelings about yourself.
Things that can help
There are ways to help with the physical effects of menopause if HRT is not suitable for you.
This can be quite uncomfortable. Vaginal dryness can make the vagina become very sore, especially during intercourse. It can also make you more prone to vaginal infections because the natural lubricating and cleaning process of the vagina is not working.
Non hormone treatments may help if you can't take hormone replacement therapy to relieve your symptoms. These include creams and moisturisers that you put into your vagina.
You use some of these a few times a week. These include Replens or Hyalofemme.
Other creams and moisturisers are used just before sex. These include Vielle, Sylk, Yes, Durex lube and Aquaglide.
Ask your doctor or nurse about whether you could use vaginal oestrogen if lubricants and moisturisers do not help. This can help to moisturise the vaginal area but we need more research to find out how safe it is after breast cancer. You can either use a cream or a pessary.
A pessary is a small pellet that you put inside your vagina, where it gradually dissolves. Your body will absorb some oestrogen but the amounts are small. Research suggests that it does not raise the levels of oestrogen in the blood very much. Talk to your doctor to see if this might be an option for you.
Hot flushes and sweats
Flushes and sweats can be difficult to control if you can't take HRT. Hormone treatments, such as tamoxifen and aromatase inhibitors can make them worse. They can last for months or years.
Research shows it can reduce hot flushes and sweats in women who are taking hormone therapy for cancer. If you are interested in trying low dose progesterone, talk to your doctor. Although progesterone is a sex hormone, many doctors think it is safe to take even with hormone dependent cancers when it is at a very low dose.
Accupuncture has been tested in trials for hot flushes. Some studies seem to show that particular types of accupuncture may help.
This treatment has been used in a couple of trials for hot flushes and they suggested that it may be helpful but we need more research to be sure.
Plant oestrogens such as evening primrose oil may be helpful for some women. There is no scientific evidence about whether evening primrose oil really helps or not. But some women say that it does.
Other herbs and vegetables that contain plant oestrogens include ginseng, liquorice root, red raspberry leaves, sarsaparilla, spearmint, damiana, motherwort, chasteberry (also known as Vitex), black cohosh, red clover and wild yams. These may reduce hot flushes for some women but it's not known how safe they are for women who have had breast cancer. Tell your doctor if you are planning to take plant oestrogens.