Understanding and Managing Menopausal Symptoms

This section is for women who are having menopausal symptoms after breast cancer treatment. We hope it answers some of your questions and gives you some practical advice on how to manage the symptoms.

Page Contents

What is Menopause?
What can you do?
Non-prescription interventions
Therapies that require a prescription
Further support
Help from Action Breast Cancer



What is Menopause?

The menopause occurs when a woman’s menstrual cycle (periods) stops and she can no longer have children. It is often called the change of life. The average age for menopause in women is 52 years. Menopausal symptoms occur because the female hormones progesterone and oestrogen are produced in smaller amounts by the body. Oestrogen is mainly produced in the ovaries and is involved in the development and growth of breast tissue. It also affects women’s physical and emotional health. Menopausal symptoms, including hot flushes, night sweats, generalised aches and pains, palpitations, vaginal dryness, lower sex drive, mood swings, poor concentration and other conditions, can be quite severe in some women and very mild in other women. Some women may experience anxiety and depression and it may be hard to work out if this is a menopausal symptom or due to a recent diagnosis of breast cancer.
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What can you do?

Hot Flushes

There are ways of improving menopausal symptoms that do not involve taking medication. All women can adopt a healthy lifestyle, such as not smoking, getting regular exercise and good nutrition. Many women find hot flushes the most disturbing problem. The following tips might help in managing hot flushes:

• Wear cotton clothing in layers. Cotton absorbs moisture and layering allows you to remove clothing as your body temperature changes.

• Use several layers of natural bedclothes that can be removed as needed.

• Use sprays or moist wipes to help lower your skin temperature.

• Aromatherapy oils, such as cooling peppermint or relaxing lavender, may be added to the spray.

• Avoid warm areas and use an electric fan to lower your skin temperature.

• Keep a record of your hot flushes to see if there is a pattern or an association with an item such as a particular place or food, especially spicy food.

• Avoid hot baths or showers as they may trigger a hot flush.

Physical activity

Regular exercise produces a sense of well-being by encouraging the body to produce natural chemicals called endorphins. Exercise is good for your heart, and weight-bearing exercises such as walking will help maintain bone strength.

Nutrition

You may find it helpful to avoid certain foods and drinks such as spicy foods, caffeine, alcohol, sugar and hot drinks. If you are overweight, losing weight can reduce your symptoms.

Vaginal dryness

Low oestrogen levels can result in vaginal dryness and irritation. Wearing loose fitting cotton underwear and loose fitting trousers can help. Vaginal moisturisers such as Replens (available from chemists) may be used every few days. If you experience discomfort during sexual intercourse, water based lubricants such as KY-jelly can be used.

Mood swings

You may find that you are experiencing extreme mood swings from very happy to very sad. These can happen unexpectedly and for no apparent reason. Relaxation classes, meditation, yoga and similar activities can be a useful way of controlling mood swings. Sometimes joining a support group where you can talk to other women with similar experiences can help. If you find you cannot cope with your mood swings talk to your doctor or breast care nurse. They may refer you to a counsellor or therapist who can help.
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Non-prescription interventions

The following items do not require a prescription. However, you should not take any of the preparations listed below without discussing them with your cancer specialist or GP.

Vitamin and mineral supplements

Vitamin E, selenium and vitamin B6 have provided relief for some women. Calcium and vitamin D supplements can help strengthen bones. Never take more than the recommended dose of supplements.

Evening primrose oil

Many women find evening primrose oil helpful. It may take many months before any improvement is noticed.

Phyto-oestrogens (plant oestrogens)

Phyto-oestrogens are thought to relieve menopausal symptoms by mimicking the effects of oestrogen in the body. They are found in most soya foods, especially soya beans, linseed, whole grains, fruits and vegetables.No clinical trials have been conducted on phyto-oestrogens so it is unknown if they could increase the risk of your cancer coming back.

Complementary therapies

Many women use a range of complementary therapies to reduce the symptoms of menopause. These therapies include acupuncture, reflexology, massage, meditation, aromatherapy and homeopathic and herbal remedies. If you decide to use complementary therapies, it is important that you go to a recognised, qualified practitioner. Always discuss complementary therapies with your cancer specialist or GP before starting any therapy.
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Therapies that require a prescription

HRT (Hormone replacement therapy)

HRT replaces the hormones that are no longer being produced by the ovaries. This is a very effective way of relieving menopausal symptoms. However, women with a history of breast cancer should try other treatments to relieve symptoms before trying HRT. For more information on HRT please: see our HRT page

For more information on HRT please call the National Cancer Helpline on Freefone 1800 200 700.

Anti-depressant drugs

There is some evidence that the anti-depressant drugs venlafaxine and fluextine can be effective in controlling hot flushes for some women.

Clonidine

This drug, mainly used to control high blood pressure, has been shown to be effective in reducing both the number and intensity of hot flushes.

Low dose progesterone

Progesterone in low doses is effective in relieving hot flushes. Megestrol (megace) and medroxyprogesterone (provera) are the most common drugs prescribed.

Other medications

Postmenopausal osteoporosis is a condition that is caused by low levels of oestrogen. It causes bones to become brittle and may result in fractures (broken bones). Selective oestrogen receptor modulators (SERMs), such as raloxifene are used to try to prevent osteoporosis. They do not lessen the other symptoms of menopause. Bisphosphonates are also used to try and prevent osteoporosis but again do not relieve other menopausal symptoms.
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Further Support

It is entirely natural to experience strong feelings as a result of a diagnosis of breast cancer, and in reaction to treatment side effects. However if you find that you are unable to cope with mood changes or if you are feeling 'down' for prolonged periods, try talking to your GP or breast care nurse.

You may find it helpful to share your feelings with someone who has had breast cancer. Reach to Recovery is a programme set up to help and support women who have recently had a breast cancer diagnosis. The programme works on the principle of personal contact between the patient and a Reach to Recovery volunteer - a woman who has had a breast cancer diagnosis. Carefully selected and fully trained volunteers are available to provide practical information and reassurance at a time when a woman is most in need of both.

For more information on individual support or support groups in your area, call the National Cancer Helpline on Freefone 1800 200 700.
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Help from Action Breast Cancer

Action Breast Cancer is a national project established by the Irish Cancer Society to provide breast cancer information and support and to fund breast cancer research. Its services are free, confidential and accessible. For more information call the National Cancer Helpline on Freefone 1800 200 700 or visit www.cancer.ie
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ABC would like to thank Breast Cancer Care in the UK for their permission to adapt the text in this factsheet from their series of factsheets.