When I was 47 years old, I was diagnosed with Breast Cancer.
During the first appointment with my Medical Oncologist (Dr M) he mentioned it was highly likely that I would “go into menopause” after chemotherapy, given my proximity to the average age of menopause (51).
“Ah, sure, OK.” I said, at least that’s what I think I would have said. My memories around this time are a little hazy. The trauma of a cancer diagnosis can do that to you.
Reflecting back on the delivery of this little nugget, I most likely thought that wasn’t a bad thing. I wouldn’t have to experience the ups and downs of menopause that I’d vaguely heard and read about. Yah me, a silver lining in a sky of very dark storm clouds.
And if these were the thoughts I was having, boy, was I in for a rude shock.
As Dr M so correctly predicted, I had what would be my very last period in the days between my breast surgery and my first round of chemo. Blood work would confirm 12 months later that I was indeed now postmenopausal.
I reached out to Luan Lawrenson-Woods who also had breast cancer and a total abdominal hysterectomy with bilateral salpingo-oophorectomy, to share her experience throughout this article also.
Menopause after cancer
Induced Menopause, which is what I experienced, occurs as a result of chemotherapy and/or radiotherapy treatment for cancers. Depending on your age and the type of chemo you receive, you may experience something more akin to a ‘period pause’ where your ovaries recover and periods recommence some months later. But for a woman my age, it was the freeway to postmenopause land, with the devil in the passenger seat and no offramps.
Women who undergo an oophorectomy (surgical removal of ovaries) will experience Surgical Menopause. I recommend this great article that further explains the different types of treatment induced menopause.
When I started noticing menopause symptoms, I was in the midst of radiotherapy and simply thought the hot flashes, night sweats and brain fog were a side effect of that treatment. I’d been through a lot in the 7 months since my diagnosis and the whole menopause thing had literally tucked itself away in the deep dark recesses of my brain.
Radiotherapy stopped. The menopause symptoms didn’t. In fact, they got worse.
Luan says “I went into surgical menopause when I had a total abdominal hysterectomy with bilateral salpingo-oophorectomy combined with phase two of my DIEP flap reconstruction. I wasn’t really offered information about what to expect, and any information I did receive was in response to questions that I asked, questions informed by my own research and experience.
I’d been in medically induced menopause since finishing treatment for breast cancer when I was 46. I wasn’t provided with any information about what to expect then either. I had no idea that heart palpitations were a symptom and was terrified when I started to experience them. When I told my oncologist, he simply dismissed them as “oh, that’s the menopause”.
So, I was keen to be as informed as possible for surgical menopause, particularly as I wouldn’t be able to take HRT because my cancer had been hormone positive.
As well as talking to my gynae surgeon, I went to a menopause clinic before my op to try and prepare myself. Both male Drs I saw told me that everyone was different, and I’d just have to wait and see what happened after surgery. Again, all the information I was given was in response to questions I asked rather than being offered.”
Menopause symptoms
Induced or Surgical Menopause symptoms are the same as a natural menopause, however they are often made worse by the cancer. This also means that identifying, managing and treating these symptoms is also much more complex. From my personal experience, not enough is done to prepare women for this or to support them post treatment.
Alongside the physical symptoms of menopause, I experienced emotional overwhelm, a loss of sexual function, distressing cognitive decline and weight gain. The mental and emotional toll of a cancer diagnosis alone was significant, add coping with menopause to that and every aspect of your life is challenged.
Quite honestly, for me it has at times been a form of hell.
It’s almost 5 years since my cancer diagnosis and induced menopause. I still have regular hot flashes, night sweats, a low libido and lingering urogenital conditions.
Due to my breast cancer being hormone dependent, I’m unable to treat my symptoms with MHT or HRT and due to inconsistent research and possible risks, have chosen not to use herbal therapies.
When I asked Luan about her symptoms she said “It’s hard to figure out ‘what’s what’ between the aftereffects of treatment, side effects from meds and being in menopause. But there’s definitely a difference between my medically and surgically induced menopause: I’m experiencing symptoms now that I didn’t before my ovaries were removed.”
“I’ve found some of the little known and little advised symptoms really upsetting, especially around cognitive performance (orientation, registration, attention, recall, and language and visuospatial skills). The ‘brain fog’ I experienced after chemo is foggier: I forget what I’m doing as I’m actually doing it; I forget words or what I’m saying mid-sentence. This has had a huge impact on my self-confidence.”
Symptom management
What I can do is manage my symptoms through a variety of lifestyle choices.
I exercise daily, including a minimum of 3 strength training workouts each week for my mental health, my bone health and the endorphins. I also take long walks in nature as often as I can.
I eat a diet high in good quality protein, fruits and vegetables. I have had lengthy periods of choosing not to drink alcohol, but currently enjoy 1-2 drinks per week. I find alcohol to be a significant trigger for hot flashes and night sweats.
I have counseling when needed, see a Naturopath regularly, take a daily Vitamin D supplement and have a brilliant network of friends that I walk and talk with on a regular basis.
I stay on top of my sleep hygiene to ensure I’m getting as much quality sleep as I can. Sleep is an area I find gets impacted really quickly if I don’t stay on top of a regular routine. I keep my bedroom dark and cool and layer up the bedding so I can flip sheets and covers on and off easily during the night. I fiercely protect my ability to get a good night’s sleep!
“In my experience” replied Luan “receiving information and treatment from health professionals has been reactive rather than proactive, so we need to inform ourselves (websites, books, forums, social media), self-advocate and engage in informed question-asking of our team.” And I couldn’t agree more.
Luan also shared that “One bit of advice I was given at the clinic when I asked about vaginal dryness and atrophy was to “use it or lose it”. It seems a flippant response, but it’s become a great mantra for all my menopausal symptoms and, while I’m still trying to find the sweet-spot in managing them, exercising my mind and body (as well as my vagina!) definitely helps.”
Supporting a woman experiencing menopause
Some women will breeze through perimenopause and menopause and transition easily into postmenopause. For others it can be a rollercoaster ride that lasts 10+ years. And for women navigating a cancer diagnosis and menopause, it can be hell.
If you are supporting a loved partner, friend or family member during this transition, stay mindful that their experience will be different to yours or different to what you’ve seen on TV or at the movies or read about in books and magazines.
No two women will experience menopause in the same way.
Written by Sonya Lovell - Founder of Stellar Women.
With contributions from Luan Lawrenson-Woods - Unwritten Me
Thank you for taking the time to read our stories. I hope that it has provided some comfort that you are not alone if you have had a similar experience with menopause. I would like to stress that this is our personal experience, and I strongly encourage you to seek medical advice to discuss your symptoms, and the management of these, that relate to your own situation.
