Managing menopausal symptoms

What are menopausal symptoms?

Menopausal symptoms are changes that happen naturally when women go through the menopause and stop producing the hormones oestrogen and progesterone (natural menopause usually happens around the age of 52).  But cancer treatments can also cause early menopausal symptoms, which can be severe to mild.

Most menopausal symptoms will eventually pass, but it can take up to a couple of years for this to happen. For some women, menopausal symptoms last for many years. The symptoms are sometimes worse if menopause has happened suddenly because of cancer treatments.

As well as the effects on your body, you may find that your confidence and self-esteem suffer if you have menopausal symptoms.

What causes menopausal symptoms?

Cancer treatments that reduce oestrogen levels or block the action of oestrogen can result in you having menopausal symptoms. For example, chemotherapy, hormone therapy, surgery that removes your ovaries or treatments that may stop your ovaries from working, e.g. radiotherapy. 

What are the most common symptoms?

Common menopausal symptoms include:

• Hot flushes / night sweats
• Vaginal dryness
• Decreased sex drive
• Mood changes
• Poor concentration
• Aches and pains
• Insomnia (sleeplessness)
• Bone thinning (osteoporosis)

Hot flushes

Hot flushes can be anything from a mild warming sensation to an unpleasant all-over hotness which causes heavy sweating. A hot flush usually lasts 4-5 minutes but can last for just a few seconds or up to 10 minutes.

Dealing with hot flushes

The following tips may help to ease the effects of hot flushes:

• Wear cotton or special wicking-fabric clothing. Cotton absorbs moisture and wicking fabrics take moisture away from the body to keep you dry and comfortable.
• Have layers of clothing and bedding so that you can remove or add layers as your body temperature changes.
• It may help to avoid certain foods and drinks such as spicy foods, caffeine, alcohol and hot drinks – try and keep a note of any food or drink that makes your flushes worse so that you can avoid them.
• Have cool drinks, avoid warm areas, use an electric fan.
• Use sprays or moist wipes, to help lower your skin temperature.
• Avoid hot baths or showers, as they may trigger a hot flush.

Vaginal dryness

Low oestrogen levels can cause vaginal dryness, irritation and discomfort during sexual intercourse. There are a number of different creams and gels available to help with vaginal dryness. Ask at your pharmacy about vaginal moisturisers and water-based lubricants. Remember to wear loose-fitting cotton underwear and trousers.

Ask your doctor about oestrogen treatments, such as rings or tablets used inside your vagina. Oestrogen products may not be suitable for you if your cancer is hormone-receptor positive.

Decreased sex drive

After cancer treatment you may have physical and emotional side-effects that can affect your desire for sex. For example, you may still be feeling tired, sad or unwell after the cancer treatment you have had or you may have other side-effects that affect your interest in sex.

Sometimes the way you feel about your body after cancer can make you feel less like having sex. These side-effects can impact on your sexuality in the months or even years after treatment.

Try to be open and talk to your partner about how you feel. Talk to your GP or cancer specialist if you are having sexual problems, as there are ways of helping you to deal with them, such as medical treatments and specialist sex therapy or counselling. For more information see sexual side-effects for women.

Mood changes

You may find that you are experiencing extreme mood changes, from very happy to very sad. A change in mood can happen unexpectedly and for no apparent reason. A few things you can try to help with your mood include:

• Relaxation classes, yoga, meditation or similar activities
• Be active , develop a daily exercise programme that suits you and stick to it
• Join a support group
• Eat a healthy diet
• Let those close to you know how you are feeling

If you find it difficult to cope with your mood changes, talk to your doctor. They may refer you to a counsellor or therapist who can help.

You can also talk to a specialist nurse in confidence by calling our Support Line on 1800 200 700 or by visiting a Daffodil Centre.

Bone thinning (osteoporosis)

Any cancer treatment that results in low oestrogen levels can lead to bone thinning and leave you more prone to fractures (broken bones). You may need to have a DEXA scan to check your bone density. Bone-strengthening drugs are available that can help if bone-thinning is a problem for you. Diet and exercise can also help to improve bone strength. We have information on bone health and cancer.

Find out more:

Bone health and cancer

Bone pain and weakened bones

Bone strengthening drugs

Other symptoms

• Aches and pains
• Poor concentration
• Difficulty sleeping (insomnia)

Relieving symptoms

Relaxation

Many women find that reducing stress can help make their symptoms less severe. Relaxation techniques like Tai chi, pilates or yoga may help.

Complementary therapies

Therapies such as reflexology, massage, meditation, aromatherapy and homeopathic and herbal remedies can help relieve menopausal symptoms for some people. Always discuss complementary therapies with your cancer specialist or GP before starting. See also Choosing a complementary therapist. Or download our booklet Understanding cancer and complementary therapies.

Dietary supplements

Phytoestrogens (plant oestrogens) are chemicals found in foods such as soya beans and linseed may help to relieve menopausal symptoms. Despite research, we are still unsure about how safe and effective they are. Talk to your cancer specialist or GP about dietary supplements before taking them.

Prescribed drug therapies

Hormone replacement therapy (HRT)

HRT tablets, patches or gels can replace the hormones you're losing and improve your symptoms. But if your cancer is stimulated to grow by hormones, taking HRT may not be suitable for you. Your doctor will discuss this with you.

Other drugs

There is some evidence that the antidepressant drug venlafaxine (Effexor®), Clonidine for high blood pressure, and anti-epilepsy drug gabapentin (Neurontin®) can help to control hot flushes. Talk to your doctor about the possible benefits and side-effects of any drug treatments that are recommended.

Other treatments

There are lots of ways of improving menopausal symptoms that do not involve taking medication. Try to have a healthy lifestyle – try to give up smoking, get regular exercise and look after your diet.

Keep active

Regular exercise has many benefits – it can improve your mood, help with sleep, keep your weight down (which can reduce symptoms) and keep your bones healthy. For more on exercising after cancer see Healthy living after cancer.

Eat well

• Eat plenty of fresh fruit, vegetables, especially dark leafy vegetables, nuts, seeds, calcium and fibre.
• Eat foods rich in calcium like milk and cheese and yoghurt, which are good for your bone health. Vitamin D helps your body to absorb the calcium.  
• Sunlight helps your body make vitamin D (so try and get some sun on your skin). Fish like salmon, tuna, and mackerel, and egg yolks also have vitamin D.
• Drink plenty of water to ensure good hydration and reduce body temperature.
• Avoid salt, saturated fats, alcohol, coffee, cola and sugary foods as much as possible.

Read more about Eating a healthy diet.

Further support

If you are concerned about your menopausal symptoms, talk to your GP or cancer specialist. Or contact your local cancer support centre where you can talk to someone who may have had a similar experience to you. Read more about Where to get emotional support.