Breast cancer and menopause

Have you had treatment for breast cancer and are suffering from menopausal symptoms?

or

And are you worried about the effects of early menopause on you due to breast cancer?

Breast cancer is very common. Each woman in the UK has a 1 in 8 chance of developing breast cancer regardless of whether they take HRT or not. 

We recognise that diagnosis and treatment of breast cancer can be a testing time! However, the sudden onset of menopause that follows it is not easy either.

You may be experiencing any of the following –

hot flushes and night sweats

anxiety, depression or mood changes

changes in memory and concentration

bone or joint aches and pains

urinary problems such as infections or incontinence

a low sex drive 

dry skin

vaginal dryness

bone thinning (osteoporosis) over some years

sleep problems

weight changes

Many women in the UK take hormone replacement therapy (HRT) to reduce menopausal symptoms. But doctors don't recommend taking HRT after breast cancer.

This is because we know that HRT can increase the risk that the breast cancer will come back. It also increases the risk of developing another breast cancer. 

However, there are many other ways of reducing symptoms when you can't take HRT and preserving your health.

1. Lifestyle changes 

To reduce the number or intensity of hot flushes, you can try the following suggestions:

Cut out coffee, tea and nicotine

Keep your room cool – use a fan if necessary

Spray your face with a cool water atomiser

Wear several layers of light clothing you can easily take off or put back on

Wear natural fibres such as silk or cotton instead of man-made fabrics

Cut down on alcohol

Sip cold or iced drinks

Have a lukewarm shower or bath instead of a hot one

Cut a towel on your bed so you can easily change it if you sweat a lot at night

If taking tamoxifen, you could try taking half the dose in the morning and half in the evening

2. Acupuncture and other alternative therapies

A review of current scientific literature suggests that there is evidence for positive impact of acupuncture on several menopausal symptoms including hot flushes, sleep disturbances, and mood swings. Similarly, there is some evidence to support the use of yoga therapy to treat hot flushes, sleep quality and stress.

3. Medicines 

There are a number of drugs that can help you to get rid of hot flushes. Venlafaxine is an anti-depressant drug that can help. It can take 3-4 weeks for it to work but it often reduces hot flushes and improves sleep.

Another drug called clonidine may reduce hot flushes, but it takes a few weeks to work.

Yet another anti-epileptic drug called gabapentin can reduce the number and severity of hot flushes for some women. 

All these medications have some side effects such as drowsiness, dry mouth or constipation but they are generally mild and temporary.

4. Femarelle range of products

These contain Tofu extract – DT56a (from soy) and improves bone health, vaginal health, joint and muscle flexibility, urinary health, energy levels and mood.

5. Treatment of vaginal dryness

You can try vaginal moisturising or lubricating products if you have vaginal dryness. These are available from chemists. 

Low dose vaginal oestrogen preparations such as vaginal pessaries are safe to use for symptoms such as vaginal dryness, irritation and painful sex even if you have had breast cancer in the past. Very little of the oestrogen is absorbed in the body.

If you worry about taking hormones vaginally (although you should not), there is a novel drug called Ospemifene which can be taken orally to get rid of vaginal dryness. It is not oestrogen and is a receptor modulator which has no effect on the breast.

6. Bone thinning 

You could be more at risk of developing osteoporosis than average if you’ve had chemotherapy that caused an early menopause. You are also at risk if you had hormone therapy such as zoladex or anastrozole or letrozole. If your menopause has been brought on early, you need to have a DEXA scan to check your bone density. 

Exercise can help to build up your bones and stop them becoming weak. This needs to be exercise that puts pressure on your bones (weight bearing exercise), such as walking, cycling or exercise in the gym. Swimming doesn't help because you are supported by the water. A number of non-hormonal medical therapies (including bisphosphonates) are available for prevention and treatment of osteoporosis. It is important to make sure that you maintain good levels of vitamin D (take supplements if required) and have a calcium rich diet.

7. Prevention of heart disease

Lack of oestrogen and early menopause can increase your risk of heart disease. Healthy diet, regular physical activity and making sure you maintain healthy cholesterol levels are important to cut down your risk of heart disease.

You don’t have to suffer in silence if you had an early menopause following breast cancer treatment!