Breast cancer and menopausal symptoms
Some cancer treatments cause low levels of sex hormones that lead to 
or menopausal symptoms.
Breast cancer treatments that cause an early menopause include:
- drugs that block or lower the amount of hormones in the body (hormone therapy)
- chemotherapy
Your menopause might be temporary or permanent. It is more likely to be permanent if you are closer to the natural age of menopause. Your doctor might be able to suggest what will happen in your situation. But this will be difficult to know for sure.
Some women have already been through the menopause. But their treatment can cause symptoms similar to the menopause.
Common menopausal symptoms
Symptoms you may have that are related to low sex hormone levels include:
- hot flushes and sweats
- night sweats
- anxiety, low mood and mood change
- feeling very tired (fatigue) and poor sleep
- loss of interest in sex
- problems with thinking, concentration and memory – sometimes called brain fog
- joint pains and muscle aches and you may have thinning and weakening of the bones (osteoporosis) over time
- headaches and worsening migraines
- itching, irritation or dryness of your vulva or vagina
- vaginal pain or discomfort during sex
- vaginal bleeding after sex
- urinary problems such as needing to wee urgently, infection or incontinence
Your fertility
Your might also be affected and you may no longer be able to have children naturally. This loss of fertility can be upsetting even if you have a family or did not intend to have children. Whether this happens to you depends on different factors. For example, your age and the cancer treatment you have had. Speak to your doctor if this is a concern for you. They can explain how likely this is in your situation.
Some women who have experienced an early menopause can still get pregnant. So you may still need to use contraception.
Who can I talk to about my menopausal symptoms?
It can be hard to know whether your symptoms are due to your cancer and its treatment. Or whether they relate to the menopause. It might help to keep a diary or make a list of your symptoms. You can discuss these with your cancer doctor, clinical nurse specialist GP or general practice nurse.
You can ask your GP surgery if there is a GP that specialises in the menopause. In some situations, your GP may refer you to a specialist menopause clinic or a gynaecologist.
Hormone Replacement Therapy (HRT) after breast cancer
Many women in the UK take to reduce menopausal symptoms. But doctors don't routinely recommend taking HRT after breast cancer.
The concern is that HRT could increase the risk of your breast cancer coming back (recurrence). The risk for women who have had breast cancer is uncertain because research so far has not drawn any firm conclusions. This might depend on the type of HRT and how long you have it.
The risk is thought to be greater in women:
- whose breast cancer has receptors for the female hormones - hormone receptor positive breast cancer
- who take HRT that contains oestrogen and progestogen (combined HRT)
It’s important that you talk to a health professional if you are finding menopausal symptoms difficult to cope with. Ideally you should speak to your cancer doctor as well as a doctor that specialises in the menopause.
Your doctor might suggest that you try other things first, such as non hormonal medicines. But they may offer HRT if your symptoms are severe. For example, if hot flushes or low mood, or a combination of symptoms are affecting your quality of life. Your doctor should discuss the risks and benefits of HRT with you.
Things that might help
For some women, HRT is the only way to completely get rid of menopausal symptoms. But there are other ways of reducing symptoms if you can't take HRT, or choose not to take HRT.
There are a range of other treatments and things you can do to help cope with the effects of menopause. You may need to try different things before you find something that works for you. And you might find that a combination of things is better than one.
We have information about ways to cope with symptoms such as:
- hot flushes and sweats
- vaginal dryness and loss of interest in sex
- problems sleeping
- bone loss
Talking, time for yourself and getting support
It can be hard to come to terms with your diagnosis at the same time as having menopausal symptoms. It might help to talk to family and friends and share how your symptoms are making you feel with your family and friends.
Try to make some time for yourself. Some people practice breathing or relaxation techniques, or mindfulness. And some people find counselling and support groups helpful.
Work and menopausal symptoms
It might help to let someone in your workplace know if you are finding menopausal symptoms difficult. It makes sense to talk to your manager first, it might be useful if some of your colleagues know as well. This all depends on how comfortable you feel about sharing what you are going through. If possible, small adaptions to your work could help. For example, flexibility of your hours, positioning your desk near a window or nearer to the toilet.
Information is available about menopause in the workplace. You can find resources on government, union and charity websites.
Sharon's breast cancer story
Sharon was diagnosed with breast cancer in 2016.
‘I’m still on medication… this causes early menopause that’s not been fun but coping well now.’
