How Do I Know If I Might Be Going Through Menopause After Cancer Treatment
You might be going through menopause if you notice some of these changes:
Hot flashes. Your face, chest, and other areas might suddenly get very hot and sweaty. You might feel your face getting red. Hot flashes usually last just a few minutes.
Night sweats. You might wake up soaked in sweat.
Genital and urinary problems. These can include vaginal and vulvar dryness, itching or irritation, painful sex, urinary frequency or urgency, urinary leaks, and more frequent urinary tract infections.
Vaginal problems. These can include dryness, painful sex, itching, irritation, and fluid from your vagina.
Bladder problems. You might leak urine, need to go more often than usual, or have trouble waiting until you can get to a bathroom. You might also get urinary tract infections.
Mood changes. These can include feeling depressed, irritable, or anxious. You might also have mood swings.
Hot flashes and vaginal dryness are more likely with chemotherapy, tamoxifen, and certain other medicines. These include anastrozole , exemestane , and letrozole .
Menopause is also linked with osteoporosis. This is a condition in which your bones are thinner and more likely to break. You may not have symptoms, so you might not know until you break a bone. Your health care provider may check you for this condition if your cancer treatment could cause it.
What Are The Effects Of Chemotherapy Induced Menopause
Impact of Chemotherapy-induced Menopause in Women of Childbearing Age With Non-metastatic Breast Cancer Preliminary Results From the MENOCOR Study The study is technically feasible, and our preliminary results underline that age in association with pre-treatment AMH level could be helpful to predict ovarian function.
Apparantly I Too Have Been
Apparantly I too have been thrown into menopause but am told it is from the radiation. Either way, I have an appointment with a naturopath to discuss this and a some other issues at the beginning of next week. Since I’m only one week post treatment, I don’t suppose I can discern between what’s menopause and what’s fatigue, and other side affects at this point. But I certainly will let you know what she shares with me.Darcee
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Treatments That Can Cause Early Menopause
Cancer treatments that can cause early menopause include:
- Surgery. Having both ovaries removed causes menopause to happen right away. If you are age 50 or younger, your provider may try to leave an ovary or part of an ovary if possible. This can keep you from having early menopause.
- Chemotherapy . Some types of chemo can damage your ovaries and cause early menopause. You may have menopause right away or months after treatment. Your risk of early menopause from chemo depends on the type and amount of chemo drug you have. The younger you are, the less likely you will have early menopause from chemo.
- Radiation. Getting radiation in your pelvic area can also damage your ovaries. In some cases, your ovaries may heal and start working again. But, if you get large doses of radiation, the damage may be permanent.
- Hormone therapy. These treatments used to treat breast and uterine cancers can often cause early menopause.
Ask your provider if your cancer treatment may cause early menopause.
Diagnosis Of Premature Or Early Menopause
Premature and early menopause is diagnosed using a number of tests including:
- medical history, family history and medical examination
- investigations to rule out other causes of amenorrhoea , such as pregnancy, extreme weight loss, other hormone disturbances and some diseases of the reproductive system
- investigations into other conditions associated with premature or early menopause, such as autoimmune diseases
- genetic tests to check for the presence of genetic conditions associated with premature or early menopause
- blood tests to check hormone levels.
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Menopause Symptoms Experienced By Menopausal Women With Breast Cancer
Research suggests young menopausal women with breast cancer may experience the following:
Hot flushes & night sweats
- Up to 80% of women with breast cancer seem to experience more severe and frequent hot flushes, compared to women with breast cancer
- Night sweats and hot flushes tend to vary with the type of treatment and can contribute to insomnia in women with breast cancer.
Of women with breast cancer, especially those taking aromatase inhibitors, 50-75% report one or more symptoms for example, vaginal dryness, itching, painful sex or urinary tract infections.
Increased depression and anxiety can be related to being diagnosed with a major illness. They are also affected by:
- the stage of the cancer
- how well treatment is going
- how well you can cope with what is happening
- the support you have.
Younger women with breast cancer can experience more physical symptoms, psychological distress and poorer sexual functioning compared to other women with breast cancer.
Chemotherapy And Birth Defect Link
There is a substantial risk of children being born with birth defects because of chemotherapy.
Particularly during the first trimester, chemotherapy greatly increases the risk of malformations. Even in the second and third trimesters, chemotherapy increases the risk of pregnancy complications and the baby being born with a compromised immune system.
Its important to use birth control methods during treatment for chemotherapy, but avoid the pill. Chemotherapy can cause nausea, and vomiting may decrease the pill’s effectiveness.
Experts also recommend avoiding hormonal birth control containing estrogen. You may want to discuss progestin-only birth control with your healthcare provider.
The copper IUD is recommended for most women undergoing chemotherapy.
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Can I Get Pregnant If I Develop Early Menopause
For most women who have developed early menopause, a natural pregnancy is unlikely, but can happen if your periods start again after lymphoma treatment.
- There are a very small number of women who appear to have gone through menopause but become pregnant naturally. This is because their ovaries still very occasionally produce eggs.
- Some women can get pregnant with medical help. This might involve using eggs or embryos that were collected and frozen before treatment for lymphoma. More often, however, in vitro fertilisation using donor eggs from another woman is needed. As menopause does not affect your womb, you should be able to carry a baby once you are pregnant, the hormones needed to support the growth of a growing baby are released.
- Adoption or surrogacy might also be options you wish to consider.
You can find out more about fertility treatments on the Human Fertilisation and Embryology Authority website.
It is important that you get good advice about your choices, so talk to your medical team and ask to be referred to a specialist if necessary.
You can also seek advice on how long after treatment for lymphoma to wait before trying to become pregnant.
How Long Do Side Effects Last
Many side effects go away fairly quickly, but some might take months or even years to go away completely. These are called late effects.
Sometimes the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs. Certain types of chemo sometimes cause delayed effects, such as a second cancer that may show up many years later.
People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your cancer care team. You may be able to change your medicine or treatment schedule. They also may be able to suggest ways to reduce any pain and discomfort you have.
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What Are Some Common Symptoms
Chemo brain is one side effect that many cancer patients report and its a real, diagnosable condition. Chemotherapy can cause it, obviously. But so can the cancer itself or even secondary medical conditions. Patients usually describe chemo brain as a foggy or slow feeling that makes it harder to process information.
Common chemo brain symptoms include:
- Trouble concentrating, particularly on just one task
- Increased short-term memory loss
- Trouble finding the right word or phrase
- Feeling mentally slow/sluggish compared to your usual self
A 2016 study researched where chemo brain comes from, and how doctors might treat cancer patients that have it. The study examined brain activity in breast cancer patients over a one-year period. At the studys beginning, researchers asked breast cancer chemo patients and control subjects to perform a Verbal Working Memory Task. Both groups then completed the same task again at five months and then one year post-treatment. The chemotherapy group performed significantly worse on the task 12 months after finishing treatment. They also had persistent neural inefficiency in executive network fMRI-activation. More plainly, women in the chemo group had more trouble concentrating, making decisions and planning things than control subjects did.
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What Can You Do To Manage Menopausal Symptoms
To help you manage menopausal symptoms, keep a record of the symptoms troubling you the most and list:
- their frequency
- their severity
- the effect they have on your daily life.
Use this information to see what changes you can consider to reduce the impact of these troubling symptoms.
Seek advice from your doctors.
Seek information from a trusted source, such as the Breast Cancer Network Australia’s ‘My journey kit’.
Visit a psychologist who specialises in emotions in chronic illness. Medicare rebates are available for up to 10 visits per year to a psychologist, as a ‘mental healthcare plan’. Discuss this with your doctor.
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Who Gets Cognitive Changes
It is not clear how many people develop problems with their concentration or memory during or after cancer treatment. Different research studies suggest quite different figures. But as many as 78 in 100 of people with cancer may be affected. It can affect both men and women.
The causes are unclear. Research suggests that it may be caused by a combination of factors. Some cancers, such as brain tumours, have a higher risk of causing problems with memory and thinking.
Other risk factors include:
- cancer treatments, including chemotherapy, hormonal therapy, radiotherapy and surgery
- treatment to the brain, such as chemotherapy into the fluid around the spinal cord or radiotherapy to the brain
- high-dose treatment with chemotherapy or radiotherapy
- side effects of cancer treatment, such as infection, low number of red blood cells , extreme tiredness , sleep problems, poor nutrition and menopause
- emotional reactions to cancer and treatment, such as anxiety and depression
- non-cancer drugs such as painkillers or anti-sickness medicines.
It is worth remembering that the benefits of your cancer treatment will usually far outweigh the risk of developing CRCC. Your doctor or nurse will be happy to talk about your treatment with you if you are worried.
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Diagnosis Of Early Menopause
- At present, there is no specific predictor of early menopause although several biochemical markers, such as anti-Mullerian hormone, are under investigation.
- The diagnosis of early menopause may take several months to confirm and can be stressful. Diagnostic criteria1 for POI includes > 4 months of amenorrhoea with a follicle stimulating hormone level in the menopausal range on two occasions at least 4-6 weeks apart.
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Which Surgeries Involve Bilateral Oophorectomy
Hysterectomy can sometimes, though not always, include bilateral oophorectomy. Hysterectomy that does not involve removal of the ovaries usually does not result in menopause. Even though menses will stop once the uterus is removed, the ovaries will probably continue to function.
Other surgeries that may involve the removal of both ovaries include:
- Abdominal resection. This is a surgical procedure done to treat colon and rectal cancer. While this surgery usually involves the removal of the lower colon and rectum, it can also include partial or total removal of the uterus and ovaries, as well as the rear wall of the vagina.
- Total pelvic exenteration. This procedure is usually only performed in cases of cervical cancer that recurs despite treatment with surgery and radiation. It involves the removal of most pelvic organs, including the uterus, cervix, ovaries, and fallopian tubes, vagina, bladder, urethra, and part of the rectum.
Cancer Survivorship And Early Menopause
Menopause can feel like a daunting hill to climb and crest even when it happens naturally many women feel concern over how their lives may change once menopause hits.
When the possibility of early-onset menopause brought on by chemotherapy is mentioned to young women with cancer, it can feel like a shock. Cancer survivors often feel like they have enough on their plate before something like this is dropped onto it. “Chemopause,” as it’s known within the cancer community, is something that few women know is a possibility until they’re informed about the condition by their treatment teams. Sometimes this change is temporary and sometimes it’s permanent, but one thing is for certain– it’s a big change. Here is some information that can help you understand what you may expect as a cancer survivor in early menopause.
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What Happens After Menopause
When your body no longer produces the same estrogen levels as before menopause, you may be at increased risk for certain health conditions. The two most serious health risk consequences of menopause are osteoporosis and heart disease.
- Osteoporosis results from rapid bone loss and slower bone creation. Bones are more likely to break if you have this condition.
- Heart disease is another health risk for postmenopausal women. Checking your blood pressure and cholesterol levels regularly is a good precaution to monitor whether you are at risk for this.
Postmenopausal women have a higher risk for these conditions for the rest of their lives, so be sure to discuss taking necessary precautions with your healthcare provider.
Tips To Improve Cognitive Function
Although no studies show the tips below improve cognitive function, they may help some people with memory problems .
Tips to improve cognitive function
Adapted from National Cancer Institute materials .
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How Can I Manage Hot Flashes And Night Sweats
Hot flashes and night sweats may be short-lived, happening only as long as youre being treated for cancer, or they may continue after treatments. The good news is there are plenty of ways to try and manage this bothersome side effect.
It may be a good idea to keep a journal of triggers that you notice so that you may avoid certain things making your hot flashes worse.
Incorporating a few lifestyle changes into your daily routinelike the ones belowmay also help minimize hot flashes.
Some integrative therapies that help patients cope with stress and anxietyincluding yoga, acupuncture, relaxation techniques and cognitive behavioral therapymay also help manage hot flashes, along with other strategies.
Why Perform An Oophorectomy
An oophorectomy causes surgical menopause. In most cases, removing the ovaries is a preventive measure against disease. Sometimes its performed alongside a hysterectomy, a procedure that removes the uterus.
Some women are predisposed to cancer from family history. To reduce the risk of developing cancers affecting their reproductive health, doctors may suggest removing one or both ovaries. In some cases, they may also need their uterus removed.
Other women may elect to have their ovaries removed to reduce symptoms from endometriosis and chronic pelvic pain. While there are some success stories in oophorectomy pain management, this procedure may not always be effective.
In general however, if your ovaries are normal, its highly recommended not to have them removed as a remedy for other pelvic conditions.
Other reasons women may want to remove both ovaries and induce surgical menopause are:
- ovary torsion, or twisted ovaries that affect blood flow
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Lymphoma Treatment And Early Menopause
Cancer treatments work by killing cells that are dividing quickly. As well as cancer cells, they can also affect some healthy cells, including those in the ovaries that are involved in the development of eggs.
When the ovaries stop releasing eggs, levels of the female hormones oestrogen and progesterone drop. This causes periods to stop. Menopause happens naturally as you get older, but it can also happen in younger women after treatment with chemotherapy, or with radiotherapy to the ovaries, resulting in early menopause.
For more videos on early menopause after lymphoma, including Juliet’s story, take a look at our early menopause playlist.
Professor Richard Anderson talks about early menopause after treatment for lymphoma, and Juliet shares her personal experience
If you develop early menopause, you are likely to experience changes in your periods. You might have them more or less frequently and they might be lighter or heavier than usual. In time, they stop altogether.
Early menopause can affect different women in different ways. However, the common symptoms include: