What is menopause? 

Menopause means that you've stopped having menstrual periods. It's a natural process that happens slowly as you age.

Menopause tends to start between ages 45 and 56. Then, over time, the ovaries make less estrogen and progesterone. This can cause symptoms such as:

• Sudden feelings of warmth (hot flashes) many times a day.

• Sweating that may seem worse at night.

• Weight changes.

• Tiredness.

• Trouble going to sleep or staying asleep (insomnia).

• Memory and mood changes.

• Low sex drive.

• Dry skin.

• Dryness and thinning of the vaginal tissues. This can cause pain with sex.

• Needing to pee (urinate) often.

• Bone thinning (osteoporosis).

• Bladder control problems.

• Irritability or mood swings.

Why menopause can happen after cancer treatment 

Menopause can happen if the ovaries are affected by cancer treatments. These treatments include:

• Surgery to remove the ovaries.

• Radiation therapy to the pelvis or lower belly. It can damage the ovaries.

• Hormone therapy such as tamoxifen. This can block the effects of estrogen and can cause menopause symptoms.

• Chemotherapy. This can cause the ovaries to shut down and can cause menopause symptoms. Symptoms may last for months or years after treatment.

In many cases, these hormone changes happen quickly. This can make menopause symptoms worse.

Menopause symptoms may go away in younger people after they've been off treatment for a while. Normal periods may even start again. But in older people, menopause is more likely to be lasting (permanent). And removing the ovaries leads to permanent menopause in people of any age. 

Talk with your health care provider about your cancer treatment. Ask if it might cause menopause. 

Managing your symptoms 

Tell your health care provider about any changes you notice. Your provider can talk with you about how to manage symptoms. Try these tips:

• Hot flashes. Wear layers of clothes that are easy to remove. Use a fan. Wear all-cotton clothing. Keep cold water nearby. Keep track of things that trigger your hot flashes. Try to stay away from the triggers. This may include spicy food, caffeine, stress, or alcohol. Losing excess weight may improve hot flashes.

• Night sweats. Use all-cotton sheets and blankets you can remove easily. Keep a glass of water and a fan by your bed. Change the thermostat as needed.

• Vaginal pain during sex. Use a water-based vaginal lubricant before and during sex. Talk with your partner about how you're feeling. Use positions that don't hurt. Tell your provider about your symptoms. Your provider may have advice to help manage and prevent pain.

• Vaginal dryness and itching. Use a vaginal moisturizer a few times a week.

• Mood swings. Try relaxation therapy or acupuncture. Limit alcohol. Get enough sleep. Talk with a cognitive behavioral therapist. They can help you manage mood changes. Ask your provider about dietary supplements and prescription medicines that may help.

• Memory problems. Get enough sleep and exercise, and eat well. Stay mentally active by taking a class, learning a new skill, or doing word puzzles. Staying socially active also helps.

• Low sex drive. Talk with your partner about other ways to be intimate when you’re not feeling your best.

• Insomnia. Ask your provider about prescription medicines that may help you get better sleep. Get regular exercise. Limit your screen time before bed. Avoid drinking alcohol, smoking, and having large meals right before bedtime. Limit caffeine after noon.

• Bladder changes. Limit caffeine. Wear pads to absorb leakage. Ask your provider about exercises that can help.

Staying healthy after menopause 

Menopause can cause some problems with a person’s health. These can include:

• Bone loss (osteoporosis). Bones can start to thin after menopause due to lower levels of estrogen. This raises your risk for bone breaks.

• Weight gain. It’s easier to gain weight after menopause. This is because of the changes in hormone levels.

• Heart disease. Estrogen protects against heart attacks and strokes. Less estrogen is made after menopause, which leads to a higher risk for heart disease. This includes problems such as high blood pressure and heart attack. 

You can help yourself stay healthy by:

• Eating a healthy diet. Healthy foods can help you manage your weight. They can lower your risk for heart disease. They may boost your mood. Talk to your health care provider or a dietitian. They can help you understand your nutritional needs and what to eat.

• Getting physical activity. Get plenty of weight-bearing activity. This includes walking or running. It can help keep bones stronger and help prevent bone breaks. Exercise can help you control your weight. It may improve mood and sleep.

• Taking supplements. Ask your provider if you should take calcium and vitamin D supplements. They can help prevent bone loss.

• Not smoking. Smoking raises your risk for heart disease and many other problems. And it’s not good for bone health. If you smoke, ask your provider about resources to help you quit.

• Getting regular tests and exams. Get bone density tests, colon cancer screenings, pelvic exams, HPV/Pap tests, and mammograms as often as your provider advises. 

About hormone therapy 

Hormone therapy helps treat menopause symptoms. It uses estrogen, progesterone, or both. It comes in pills, creams, gels, rings, caps, sprays, and patches. But after cancer you may not be able to use it because it may raise your risk of cancer coming back. It depends on the type of cancer you had. Using nonprescription bioidentical hormones from plant sources may raise your risk.

Talk with your health care provider about the risks and benefits before you start any kind of hormone therapy. They can tell you if it’s safe for you. 

Working with your health care provider

As you move on to life after cancer, work with your provider to help you manage menopause symptoms. Make sure they know about your cancer history. Talk about your symptoms. You can work together to help you feel better. If your symptoms are very bad and affect your daily life, you may be given medicines that can help. 

Some herbs and supplements may help reduce menopause symptoms. But talk with your provider before taking any of them.