Menopause can be a challenging transition for many women, causing them to wonder about how much “the change” will affect their lives. 

Hearing that early-onset menopause can be brought on by chemotherapy can be a shock to young women with cancer. This can make cancer even more difficult to deal with. “Chemopause," as it's known within the cancer community, is rarely general knowledge. In fact, most women don’t learn about it until they’ve sat down to talk with their cancer care team. 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. Below is 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

Various cancer treatment options can trigger treatment-induced menopause, including:  

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

As the name “chemopause” suggests, chemotherapy is seen as the most common cause of early-onset menopause. The reason being is that certain medications used in chemotherapy treatment tend to damage the ovaries. It’s this damage that leads to menopause.

Once the ovaries are damaged, they produce less female hormones like estrogen, which is what causes 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 halt. 

It’s important to understand that the length of menopause varies among patients. Depending on the patient, menopause can last anywhere from the length of treatment to the rest of their life— and unfortunately, there is no guaranteed way to predict the duration of each individual experience. While it can be tough for a woman to hear that there's no answer to when her fertility may straighten itself out, it’s a reality of treatment that all women with cancer should consider and be prepared for. 

The likelihood of a woman's menstrual cycle returning is dependent on several factors, such as your age before the start of treatment and which drugs are used in that treatment. With that said, it’s important to keep a cool head during the process and not bet on any particular outcome. 

Symptoms of Cancer Treatment-Induced Menopause

Treatment-induced menopause can add to the many battles cancer survivors already encounter. Symptoms of premature menopause can sometimes be more severe than if menopause had been reached naturally, due to the abrupt nature of treatment-induced menopause. Menopause, both treatment-induced and classic, share many of the same symptoms that include: 

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

It can be difficult to manage so many symptoms when you've already experienced cancer survivorship and are dealing with other side effects of cancer treatment. Even though emotional issues and depression are common factors in cases of typical menopause, 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, it is important that you have a talk with your oncologist or cancer care team. Even before you begin treatment, you should have a conversation 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.

It’s important that you maintain an open line of communication with your cancer care team, both during and after treatment. Doing so can make the difference between living in fear and having hope for 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)

Hormone replacement therapy that uses estrogens and progesterone can greatly ease the effects of treatment-induced menopause. However, due to the complexity of HRT, this is a topic best discussed with your medical 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 you should go through this type of therapy.  

Antidepressants

Antidepressants are a non-hormonal treatment option that benefits some women. One clinical trial even indicated that women who took antidepressants every day experienced a 61% reduction in the frequency of their hot flashes. Some women may also experience some relief from the emotional highs and lows that can come with menopause by taking antidepressants. 

Lifestyle Changes

There are some other, less-direct methods that can be used to manage menopause, which include: 

• Consuming less spicy foods, caffeine, and alcohol in order to help reduce occurrences of hot flashes
• Wearing light, breathable clothing to help reduce physical discomfort from hot flashes
• 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
• Engaging in regular, gentle exercise in order to relieve emotional symptoms

We encourage you to speak with your Minnesota Oncology cancer care providers if you or a loved one has concerns about, or, is experiencing premature menopause caused by cancer treatment. The more forthcoming you are about your mindset surrounding potential or past treatment plans, the better we can find ways to offer you relief and steer you towards health.