Can I become menopausal from my treatments?

Gynaecological issues concern all women.  For those battling with a diagnosis of breast cancer, this is even more important. Dr Sumayya Ebrahim addresses the gynaecological consequences of breast cancer treatments providing current and relevant information aimed at helping patients, care-givers, loved ones and partners.

In the past breast cancer mainly affected older women already in their menopause. It is now not uncommon for breast cancer to be diagnosed in much younger women who are still of childbearing age.

The likelihood of a woman becoming temporarily or permanently menopausal as a result of treatment depends mostly on her age and the type of treatment. Current breast cancer treatments involve surgery, radiation, chemotherapy and anti-oestrogen treatment (e.g. Cyclophosphamide, Tamoxifen and Aromadex). These are used in various combinations depending on the age of the patient and the stage of the disease.

Cyclophosphomide (used in most chemo therapy regimens for women with hormonal receptive cancer) is considered highly toxic to the ovaries. Studies show that 15% of 35-year-old, 40% of 40-year-old and 75% of 45-year-old women were menopausal one year after this type of therapy. If Tamoxifen is also used the risk of menopause increases.

So, women under 40 tend to lose their menstruation temporarily. But menopause seems to happen sooner in women over 40 and is less likely to be reversible.

What are the symptoms of menopause?

The early and immediate symptoms are: – hot flushes – irritability – heart palpitations – insomnia – inability to concentrate – forgetfulness – amenorrhea (absence of a period) – headaches – depression – weight gain – joint pain – decreased sex drive.

These symptoms are often the ones that lead women to seek medical attention. The cancer diagnosis and treatment can cause many of the same symptoms and this can be confusing. If you are unsure as to the cause of your symptoms you must discuss it with your supervising doctor.

How can these symptoms be treated safely?

Hormone Replacement Therapy (HRT) is not generally recommended for breast cancer survivors. This is mainly because of concerns that the cancer will worsen or that cancer could recur. Alternatives to HRT have to be the first line of treatment such as Dixirit for hot flushes; antidepressants for anxiety, depression and mood swings; gingko biloba for forgetfulness and loss of concentration and paracetamol-based painkillers for headaches.

These are just some examples of treatment options. Most of these require prescriptions.  Always discuss your symptoms with your oncologist or gynaecologist. They may have other useful non-medical suggestions.

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