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Menopause and Menopausal Symptoms

HOME > LIFE WITH CANCER > TREATMENT AND SYMPTOM MANAGEMENT > MENOPAUSE AND MENOPAUSAL SYMPTOMS
Breast cancer and its treatment can lead to a variety of issues related to your body's natural cycles. Menopause is when menstrual periods stop permanently. When this happens, the ovaries stop producing estrogen and no longer release eggs (ovulation).
Menopause happens naturally as women age. Sometimes medical issues or treatment can cause menopause to occur early or abruptly. Breast cancer treatments may causes temporary or permanent menopause. 
Spontaneous (natural) menopause
Individuals in their 40s or 50s undergo natural menopause as eggs are used up and their ovaries gradually stop producing estradiol, an estrogen hormone. This is called spontaneous menopause and it is considered complete when a person goes through 12 consecutive months without having a period.
Induced (premature) menopause
Induced or premature menopause happens when health issues cause your menstrual cycle to stop. Two treatments that can cause this in young adults with breast cancer are chemotherapy and oophorectomy, which is surgical removal of the ovaries. Most young breast cancer patients do not go through menopause right away with treatment, even if they've had chemotherapy.
However, chemotherapy may damage the ovaries and reduce fertility. This often results in amenorrhea (irregular periods or no periods at all). Even if periods do continue, ovarian damage from chemotherapy can lower estrogen levels in the body and lead to symptoms of menopause. In addition, medications like ovarian suppression shots or those that block estrogen (like tamoxifen) or lower estrogen (like aromatase inhibitors such as exemestane, anastrozole, and letrozole) may also cause symptoms, even though their effects may be temporary. These hormonal treatments may also cause changes in periods without causing menopause.

Highlighted Webcast:


​Managing Menopausal Symptoms for Breast Cancer Survivors
Related Topics:
Sexual Health
Physical Activity
​Nutrition
Fertility 
Chemotherapy 
Hormonal Therapy

 
Menopausal symptoms
Whatever the cause, menopausal symptoms vary widely from one person to another. The good news is that there are concrete ways to deal with most of them if and when they do arise. 

Common symptoms include: 
  • Hot flashes and night sweats
  • Sleep problems
  • Sexual changes 
  • Memory and mood disturbances
  • Urinary and vaginal problems 

Other issues include: 
  • Bone health
  • Weight gain
  • Heart disease (slight risk)

​For more information, read a Dana-Farber teaching sheet about cancer and menopause.
 
Hot flashes and night sweats
Those going through menopause often experience hot flashes. The blood vessels (in the head and neck in particular) open wider than usual and allow more blood to flow through. This results in sudden and intense heat sensations.

Hot flashes can lead to sweating, redness, or a racing heart. They can last from a few seconds up to 10 minutes, but on average, they last about 4 minutes. Here are some ways to ease the discomfort:


Avoid triggers that may lead to hot flashes. It helps to figure out if you have triggers and what they are. They are unique to each person, but common examples are:
  • Stress
  • Spicy foods
  • Caffeine
  • Diet pills
  • Smoking
  • Alcohol
  • Hot showers, hot tubs, saunas
  • Hot weather

Pay attention to your clothes.
  • Dress in layers.
  • Wear loose clothing.
  • Keep air circulating by opening windows or using a fan.
  • Wear fabrics, like Polypro, that pull moisture away from the body.

Cool down. Place a cool pack on the back of your neck.
​
Exercise. Physical activity is good for your general health. It can also reduce hot flashes.

Try alternative treatments. Try biofeedback, acupuncture, or vitamin and mineral supplements approved by your doctor.

Ask about medication. If none of these suggestions work, medication might help. Talk with your doctor about the best options for you.


Read a Dana-Farber teaching sheet about hot flashes and excessive sweating. 
Return to Menopausal Symptoms
 
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Sleep problems
Some people find that menopausal symptoms like night sweats disturb their regular sleep patterns. If you have trouble falling asleep or staying asleep, try some of these techniques:

  1. Follow a regular schedule. Go to bed at the same time each night and get up at the same time each morning.
  2. Watch what you eat and drink. Avoid heavy meals, caffeine, nicotine, spicy foods, and alcohol at night. These can all interfere with sleep.
  3. Get some physical activity during the day. Working out too close to bedtime can make it hard to get to sleep. 
  4. Create the right atmosphere. Make your bedroom cool, dark, and quiet.
  5. Ask about medication. If these changes aren't enough, ask your doctor about medications. They help some people break a cycle of insomnia (not being able to fall asleep or stay asleep) and jump-start regular sleep patterns. Keep in mind that these medicines can be habit-forming and have some side effects. You should only use them for a short time.

If you are taking tamoxifen, you may want to avoid sleep medications with diphenhydramine. This is the same thing as Benadryl and is also used in other medications, like Tylenol PM. Some studies suggest that it may reduce tamoxifen's effectiveness.

Read a Dana-Farber teaching sheet about managing sleep problems.

Return to Menopausal Symptoms
 
Memory and mood
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According to new research, estrogen may be important for nerve cell function in the brain and for memory. So, lower estrogen levels during menopause can cause people to:
       
         Become forgetful

         Have trouble finding words
         Have trouble concentrating
​


These problems may also be related to sleep deprivation, depression, or stress. To try to deal with this problem (regardless of the cause) we recommend focusing on one thing at a time (avoid multitasking), writing things down rather than trying to memorize everything, and trying to stay organized. 

Read a Dana-Farber teaching sheet about concentration and memory problems.​

Return to Menopausal Symptoms
 
Depression
Those who go through early menopause, either natural or induced, may feel depressed. Symptoms include:
  • Losing interest in normal activities
  • Sadness
  • Weight loss or weight gain
  • Feeling hopeless or helpless
  • Irritability
  • Constant tiredness
​
Having breast cancer can also cause depression. Young adults with breast cancer are most vulnerable to depression when they are first diagnosed and when treatment ends. If you have a history of clinical depression, let your doctor know. If your symptoms continue over time, don't ignore them; get help.
Return to Menopausal Symptoms
 
Anxiety
It's normal to feel anxious about menopausal symptoms or menopause. However, anxiety that lingers or gets worse can become overwhelming. This can cause:
  • Insomnia
  • Fatigue
  • Muscle tension
  • Trembling
  • Headaches
  • Hot flashes
  • Irritability
  • Chest pain, shortness of breath, or palpitations (racing heart sensation)

These issues can make it hard to function at home or at work. Most people find they can get control of ongoing anxiety with mental health counseling and/or medication. Speak to your doctor if you are experiencing these symptoms. 

For guidance around managing anxiety or depression, talk to a social worker at Dana-Farber.
​
Read a Dana-Farber teaching sheet about mental and emotional health.
Return to Menopausal Symptoms

 
Urinary and Vaginal Problems
​Urinary symptoms
Estrogen affects many parts of the body, including the bladder. During menopause, reduced estrogen levels weaken the muscles that surround the bladder and hold in urine. This can cause:
  • Frequent urination
  • Urinary incontinence
  • Painful urination
  • Recurring urinary tract infections

Kegel exercises can help to strengthen the bladder muscles.
Return to Menopausal Symptoms
Vaginal symptoms
Changes during menopause can include thinning of the tissues in the vagina and cervix, as well as vaginal dryness. This can result in:
  • Pain or bleeding with sex
  • Genital itching
  • Increased discomfort during routine pelvic exams

For suggestions on addressing some of these issues, visit our sexual health page or talk with your doctor. ​
Return to Menopausal Symptoms
 
Bone health
Early menopause and some breast cancer treatments can affect your bone health. Aging and decreasing estrogen levels can cause bones to thin over time. To avoid this problem, be sure to:
  • do weight-bearing exercises regularly
  • get enough vitamin D
  • get enough calcium 

To monitor your bone health, speak to your doctor about a bone mineral density test. 
Return to Menopausal Symptoms
 
Weight gain
Menopause causes some adults to gain weight and/or have trouble losing weight. This can be caused by:
  • changes in estrogen levels
  • reduced physical activity
  • increased food intake
  • the natural slowdown of metabolism because of age

All young adults should make exercise a priority. If exercise is not part of your regular routine already, talk to your doctor before you begin. Read more on physical activity. ​
Return to Menopausal Symptoms
 
Heart disease
Heart disease is the leading cause of death in women. Those who have gone through natural menopause and those going through early menopause are at slightly increased risk for heart disease. Postmenopausal adults with other risk factors have an even higher risk. Risk factors for increased heart disease include:
  • Diabetes
  • Smoking
  • High blood pressure
  • High LDL ("bad") cholesterol
  • Low HDL ("good") cholesterol
  • Being overweight
  • Little or no regular physical activity
  • Family history of heart disease

The best treatment for heart disease is not actually treatment at all; it's prevention! You can cut your risk of heart disease during and after menopause by:
  • Eating healthy 
  • Not smoking (or being around secondhand smoke)
  • Exercising regularly, now and in the future
Return to Menopausal Symptoms

Additional Resources

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©2020 Young and Strong Progam at Dana-Farber Cancer Institute
  • About
    • Meet the Team
    • Clinical Sites and Services
    • Research Studies
    • Supporting the Program
    • Contact Us
  • Newly Diagnosed
    • Understanding your Diagnosis
    • Genetics and Family History
    • Treatment Types >
      • Chemotherapy
      • Surgery
      • Radiation
      • Hormone Therapy
    • Building Your Network of Support
    • Coping with Your Diagnosis
    • Coping As A Family
  • Life with Cancer
    • Treatment and Symptom Management >
      • Menopause and Menopausal Symptoms
      • Fertility
      • Sexual Health
      • Lymphedema
      • Tips for Managing Symptoms
    • Supporting and Engaging Your Body >
      • Nutrition
      • Physical Activity
      • Style and Comfort
      • Health and Wellness Tips
    • Logistics: Managing the Details of Your Life >
      • Work and School
      • Financial Supports
      • Getting Organized
    • Finding Community >
      • Early Stage
      • Inflammatory Breast Cancer
      • Metastatic Breast Cancer
  • Survivorship
    • Survivorship Clinic
    • Life Post-Treatment
    • Continued Support
    • Pregnancy After Breast Cancer
    • Volunteer Opportunities
  • Caregivers
    • Resources for All Caregivers >
      • Getting Organized and Managing Logistics
      • Expanding Your Circle of Support
      • Coping: Cancer Impacts Everyone
    • Resources for Family Members >
      • Family Connections
      • Genetic Testing
    • Resources for Partners >
      • Future Pregnancies
  • News & Events
    • Upcoming Events
    • Webcasts
    • 2022 Forum Recordings
    • 2021 Forum Recordings
    • Newsletters
    • Insight Blog
    • COVID-19 and Breast Cancer