Menopause and cancer

Some cancer treatments can cause side effects similar to menopause symptoms. If you are a younger person having periods, you may experience an early menopause. The terms medically induced menopause, surgical menopause and chemical menopause are sometimes used.

It can feel emotionally and physically challenging to face the symptoms and implications of the menopause on top of those caused by your cancer, diagnosis and treatment. There are ways to manage and reduce the symptoms you might experience, and Maggie’s is here to support you.

Menopause and cancer explained

The menopause is a natural part of the aging process caused by a change in hormone levels. Your ovaries gradually produce less oestrogen and progesterone, your periods stop, and pregnancy becomes no longer possible. It usually happens to people between the ages of 45 and 55, and it can happen to some transgender men and non-binary and intersex people too.

Some cancer treatments can affect your hormones and trigger menopause symptoms or an early menopause.

In women, these treatments include:

• chemotherapy
• surgery to remove both ovaries
• radiotherapy to the pelvis
• drugs that block or lower the production of certain hormones in the body (hormone therapy).

Early menopause is when your periods stop before the age of 45. In some cases, the menopause caused by your cancer treatment will be temporary, but for others it will be permanent. It depends on the type of treatment you’re having, and how near you are to your natural menopause age. 

Treatments for gynaecological and breast cancers commonly cause menopause symptoms or early menopause in women, but treatments for other cancers can cause these side effects too.

Even if you have already been through the menopause naturally, you may experience menopause symptoms again during cancer treatment. This is especially the case with some hormone therapies for breast cancer or having surgery to remove your ovaries.

Men can also experience menopause symptoms during treatment for certain cancers. This is sometimes called the male menopause, or the andropause. Hormone therapy for prostate cancer or male breast cancer reduces or blocks the production of testosterone, causing many of the symptoms associated with the menopause. This can affect some transgender women and non-binary and intersex people too.

Menopause symptoms

The change in hormone levels during the menopause can cause various symptoms, which can be physical, physiological or psychological. They are often experienced more intensely when the menopause is caused by cancer treatment, because your hormone supply will stop more suddenly.

Menopause symptoms can affect different areas of your daily life, including your relationships, social life, work, and physical and mental wellbeing. This can feel like a lot to deal with when you are also facing the other challenges that cancer brings.

Symptoms of the menopause include:

• anxiety
• ‘brain fog’, cognitive change and problems with memory and concentration
• difficulty sleeping
• feelings of loss of identity and self confidence
• hair changes, including hair loss, thinning and an increase in facial hair
• headaches and migraines
• hot flushes
• irritable bladder
• joint stiffness, aches and pains
• mood changes, including low mood and emotional dysregulation
• night sweats
• palpitations
• recurrent cystitis and urinary tract infections (UTIs)
• reduced sex drive (libido)
• skin changes
• vaginal dryness and discomfort
• weight changes.

Men going through hormone therapy for prostate cancer or breast cancer can experience many of these symptoms too, as well as erectile dysfunction and breast enlargement (gynaecomastia).

It can feel overwhelming to go through a medically induced menopause and experience symptoms during your cancer treatment. Our Cancer Support Specialists are here to talk through whatever it is you are facing and help you find the information and support that’s right for you. There may also be sessions, workshops and support groups that will provide further information on managing side effects, emotional support and advice on bone and heart health. Visit your local Maggie’s centre to find out more.

Menopause treatments

There are several medical and non-medical interventions that can help you manage your menopause symptoms and your long-term health and wellbeing. It is important to speak with your doctor to discuss them, because certain interventions may interfere with your cancer treatment.

Non-medical menopause interventions

• Cognitive Behaviour Therapy (CBT) workshops
• Acupuncture
• Clinical hypnotherapy
• Herbal products and supplements

You may have heard of some herbal products for relieving menopause symptoms, but some of these are not recommended for people with cancer. Black cohosh can cause liver toxicity and interact with certain medications, so should be avoided. St John’s Wort may also interact with certain cancer drugs, such as Tamoxifen. There is also an ongoing debate about whether red clover and isoflavones should be taken by people with breast cancer. While soya products are fine to consume as normal, soya supplements are not recommended.

Other products like evening primrose oil or sage are sometimes suggested. Always speak with your cancer doctor to discuss interventions for relief of menopause symptoms before taking any products. Cancer Support Specialists at your local Maggie’s centre will be able to offer you more information on these interventions before you speak with your doctor.

Medical menopause interventions

If you are below 60 years of age and your cancer is not oestrogen sensitive, then you may be able to take Hormone Replacement Therapy (HRT). HRT replaces the hormones oestrogen and progesterone, which fall to low levels during the menopause. There are many different types of HRT, and your healthcare team will be able to talk you through your options.

There are also non-hormonal medications that you may be able to take to ease symptoms. Speak with your cancer doctor, and they can prescribe the medication that is right for you.

Menopause implications

The change in hormone levels during the menopause can negatively affect your bone health and heart health in the long term. Your risk of developing dementia is also increased. If you are experiencing early menopause or medically induced menopause, your hormone levels will fall earlier than normal, so it is important for you to take measures to reduce these risks.

HRT restores the levels of your hormones that drop during the menopause, helping to mitigate the implications of early menopause on long-term health. The National Institute for Health and Care Excellence (NICE) recommends HRT for anyone under the age of 50 experiencing a medically induced menopause who has a non-oestrogen sensitive cancer. Your cancer doctor will be able to advise whether HRT is an option for you.

Taking Vitamin D supplements (800-1000 IU or 20–25 mcg a day) and increasing your calcium intake to 1000–1200mg a day will also help maintain your bone health. Vitamin D helps your body to absorb calcium, and it is most effective when taken as an oral spray.

Lifestyle changes

There are also some positive lifestyle changes you can make to help you cope with a medically induced menopause and its symptoms.

• Eat a healthy, balanced diet, including calcium-rich foods
• Regular, gentle exercise, including activities where you are on your feet, such as walking
• Get lots of rest and sleep
• Maintain a healthy weight
• Reduce intake of salt, alcohol and caffeine
• Stop smoking
• Do relaxing things to manage your stress and anxiety, such as massages and acupuncture
• Understand your triggers and plan ahead

For example, hot flushes can be set off by hot rooms, spicy food, hot drinks, restrictive clothing, stress and anxiety. Wearing light layers, loose fitting clothes and carrying a hand-held fan may be helpful. At night, consider sleeping on a towel or cotton sheets and use a thin duvet and a self-cooling pillow. See our page on hot flushes and cancer for more advice on managing this symptom.

Maggie’s runs a range of workshops on nutrition, sleep, menopause and managing stress, as well as activities like yoga, tai chi, meditation and gentle exercise. Contact your local Maggie’s centre for more information.

Fertility concerns

You may have concerns about the impact of your cancer treatment on your fertility, whether you were planning a family soon or not. It is important to raise your concerns to your doctor early on before treatment starts. They can discuss any possible measures to preserve your fertility at this point.

The emotional impact of loss of fertility or uncertainty around fertility can be very difficult, and it is understandable that you may need extra support. You can find out more in our section on fertility and cancer or speak to a Cancer Support Specialist at your local Maggie’s centre.

Managing the menopause and cancer

An early menopause or menopause symptoms can seem like another big step in a life already affected by cancer and its treatments. You may have lots of questions for your doctor about menopause treatments and managing your symptoms, or you may be feeling overwhelmed and unsure what to ask.

Here are some points to consider when discussing your early menopause or menopause symptoms with your healthcare team.

• Find out about the cancer treatment you’re having, and whether this will cause an early menopause or menopause symptoms.
• Ask whether the menopause will be temporary or permanent, and the possible impact on your fertility.
• If you are experiencing early menopause, ask your healthcare team how they will monitor your bone and heart health in the years post menopause.
• If you are receiving cancer treatment and you are finding the symptoms of the menopause severe, talk things through with your doctor or a specialist nurse. There are different ways the symptoms can be managed, and there are medications that your doctor can prescribe to help. Your healthcare team needs to know about how the menopause is affecting you to help you find the best way to manage these symptoms along with your cancer treatment.
• If you were going through the menopause naturally before your cancer diagnosis, you may have been on HRT. In some cases, HRT will be stopped, particularly if your cancer is hormone sensitive (such as breast or endometrial cancer). Stopping HRT suddenly can bring on a surge of menopause symptoms. Speak to your doctor about the best ways to manage this.
• A common symptom of menopause is vaginal dryness, which can be uncomfortable, cause bladder infections and impact your sex life. This can be especially upsetting at a time when you may already be feeling vulnerable or lacking confidence with intimacy. Ask your GP or specialist nurse about creams and lubricants that can help ease the symptoms.

If you are looking for more guidance on speaking to your healthcare team about your menopause and cancer, visit your local Maggie’s centre. Our Cancer Support Specialists are here to listen and support you, offering advice and information that is right for you.

When to seek further help

Many cancer symptoms interlink with the menopause. At times, it can be hard understand whether you are experiencing menopausal symptoms, treatment symptoms or side effects of medication.

• If you notice any new symptoms, or are concerned in any way, let your healthcare team know.
• If you notice vaginal spotting or bleeding after your periods have stopped, inform your healthcare team, as some treatments may cause this problem.
• A medically induced menopause or menopause symptoms may be intense, particularly if you are in your twenties or thirties. It can feel a lot to deal with on top of your cancer treatment. Tell your doctor if it feels like you are struggling to cope, and they will be able to help you.
• The menopause can add to feelings of low self-esteem, anxiety and depression. If these symptoms are affecting you daily and you are finding it emotionally difficult to deal with, let your healthcare team know. It might feel hard to reach out for support, but it can be a positive step to reducing the impact. Opening up to family and friends and finding support at a Maggie’s centre may also help. Ask about cancer support groups at your local Maggie’s centre.

What now?

Look at the blogs and links on this page to find out more about coping with early menopause or menopause symptoms caused by your cancer treatment.

You may want to talk with others about what you are experiencing. It can help to hear that what you’re feeling is not unusual. Visit your local Maggie’s centre to talk to our Cancer Support Specialists and connect with others in a similar position to yourself.

For more information, you can join our online workshop on Menopause and Cancer, run by Lisa Punt, Centre Head at Maggie’s Cambridge. To join the next workshop or ask any questions about menopause and cancer, email Lisa at lisa.punt@maggies.org or call Maggie’s Cambridge on 01223 249220.

Last review: Oct 2023 | Next review: Oct 2024