If you’re a woman who’s navigating cancer treatment, it’s important to talk to your doctor about cancer therapies that can potentially contribute to the onset of menopause and prepare you for its side effects. Medically induced menopause is sometimes an unexpected side effect that needs more awareness and discussion.

While all women go through menopause at some point (the average age is 52), there are some women who go through medically induced menopause rather early and quickly as a result of their cancer treatment. The experience can feel challenging, but support is here. Knowing what to expect allows you to prepare for changes and take steps to ease symptoms from the start.

This month, as we collectively recognize World Menopause Day, it’s important to do our part in educating women about menopause, as well as offer words of encouragement and advice to anyone entering this phase of life. 

What is medically induced menopause?

First, it’s important to understand natural menopause, which is typically diagnosed in women who are in their 40s or 50s and haven’t experienced a menstrual period or bleeding in 12 months. While the average age is 52 years old (with 95% of women reaching menopause between ages 45 and 55), menopause timing can vary depending on a woman’s overall health and lifestyle, and the symptoms can vary from person to person as well. 

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Medically induced menopause, also known as chemical menopause, happens when a woman’s ovaries are surgically removed, when they’re shut down because of medicine, or when they stop working due to a cancer treatment like surgery, chemotherapy, hormone therapy, or radiation. When your ovaries stop working, estrogen and progesterone levels can drop very quickly, causing you to immediately enter menopause and experience side effects.

How is cancer treatment specifically linked to medically induced menopause?

For some women going through breast cancer, ovarian cancer, endometrial cancer, or cervical cancer, their treatment path may quickly lead to menopause as well. For example:

• During treatment for breast cancer, patients may take drugs to suppress their ovarian function, have an oophorectomy to surgically remove their ovaries, or need to take chemotherapy that can damage their ovarian function. The goals of these treatments and procedures is to reduce estrogen levels to prevent breast cancer recurrence or slow the growth of a tumor. 
• During treatment for ovarian cancer, patients are typically treated with the surgical removal of their ovaries and fallopian tubes, and potentially their uterus. For pre-menopausal women, this immediately causes menopause. 
• During treatment for endometrial (or uterine) cancer, the standard treatment is often both a hysterectomy and an oophorectomy. The removal of these reproductive organs again leads to menopause.
• During treatment for cervical cancer, women may need surgery to remove their ovaries or need to go through pelvic-area radiation that can also damage ovarian function and induce menopause. 

What are the symptoms of medically induced menopause?

While many of these symptoms are universal to women experiencing both perimenopause and menopause, they are also important symptoms for those going through cancer treatment and undergoing medically-infused menopause as well, including:

• Hot flashes
• Bone and cardiovascular concerns
• Vaginal dryness or a decrease in libido
• Mood swings, fatigue, and anxiety
• Weight gain, especially around the midsection
• Challenges with concentration 
• Changes in skin and hair, from texture to itchiness 

How can I cope with medically induced menopause?

• Manage hot flashes with alternative therapies like yoga and acupuncture. 
• Take a fresh look at your diet and incorporate calcium-rich foods.
• Talk to your doctor about exercise and how it can help with fatigue and pain as well. 
• Trouble sleeping? Try not to eat or drink before bedtime, and if you must then consider warm caffeine-free tea. If you’re having urinary issues through the night, talk to your doctor about treatment. 
• For vaginal dryness or decreased libido, consider lubricants, moisturizers, vaginal estrogen, or talk to your care team about prescription options as well.

Vaginal estrogen can be an effective way to manage vaginal dryness, according to medical oncologist Dr. Eleonora Teplinsky. “Vaginal estrogen is a great option, especially for people who’ve not had a good response to the non-hormonal vaginal moisturizers. It doesn’t get absorbed into the circulation, so when they’ve monitored estrogen levels in the blood, they haven’t seen a bump for people using vaginal estrogen,” she says.

For a full list of suggestions, check out The Menopause Society website for advice, and remember –  medically induced menopause is a lot to manage, but you’re not alone. With support from medical experts and friends, you can learn to tackle some of your symptoms and protect your peace of mind as well. 

As always, if you would like to connect with an Outcomes4Me oncology nurse practitioner at no charge through the Outcomes4Me app, just use the “Ask Outcomes4Me” button.