My breast cancer treatment has induced an early menopause
Guest blog by Sara Liyanage, creator of
Ticking Off Breast Cancer
Sara founder of Ticking Off Breast Cancer, a website dedicated to helping people through their breast cancer treatment, from diagnosis to living life to the full once treatment ends, is a Hot Flush heroine. Diagnosed with breast cancer,aged 42, Sara decided to set up a website to support those who don’t know which way to turn for help after receiving a breast cancer diagnosis, those who are overwhelmed by the breast cancer resources online, those who may be scared to go online for fear of what they might find, and those just looking for a comfortable, safe, calm place to turn for help. The website provides practical advice for each step of the way, together with many links and signposts to other online resources.
A couple of years ago I would never have given the menopause a second thought - it was something that ladies of a certain age went through: silently and stoically, not complaining but quietly coping with a few hot flushes and surely enjoying the lack of periods. And then, one day just after starting chemotherapy for breast cancer, I was sitting in my oncologist’s office and he nonchalantly mentioned that there was a likelihood that my treatment could induce an early menopause. What?! The menopause at 42? On top of everything else that I was going through? Apparently yes: it transpires that some breast cancer treatments can cause an early menopause. And it turns out that it isn’t just hot flushes and no more periods.
When my periods stopped after one month of chemo, I asked my oncologist whether this was the menopause. He replied that it was too early to tell – we would have to wait and see whether my periods came back after treatment ended. In fact, we were to wait for one year after the end of chemo and if I didn’t have a period within that year then I was most likely going through the menopause.
During my six months of chemo I experienced every menopausal symptom under the sun. But those symptoms are also side effects of chemo so I couldn’t tell whether, say, a hot flush was down to the chemo coursing through my body or due to the menopause. Chemo ended in May last year and I have just passed the one year “end-of-chem-versary” having not had a period since December 2016. I have also continued to experience every possible menopausal symptom since chemo ended, which clearly indicates to me that I am, in fact, going through the menopause.
I had hoped that once chemo and radiotherapy were out of the way, I would be able to focus on my physical and emotional recovery from breast cancer treatment. Instead, for the past year I have been experiencing the full range of menopausal symptoms which have prevented me from making the recovery that I had hoped for. And they show no sign of dissipating. The symptoms permeate every aspect of my life: night sweats contribute to my lack of sleep; anxiety bubbles away under the surface exploding every now and again in the form of never previously experienced panic attacks; unpleasant, intrusive and embarrassing hot flushes come out of nowhere on a daily basis; a general fatigue prevents my already low energy levels from increasing; I am desperately trying to prevent my lack of libido and vaginal dryness from impacting upon my marriage; all sorts of emotional ups and downs add to my low confidence and low self-esteem; and I have the added worry of watching my weight, loss of bone density, joint pain, itchy skin and brain fog to deal with.
Yes, I have thankfully come out of the other side of breast cancer and for that I am immensely grateful. Now, however, I feel like I have another hurdle to overcome before I can properly move forward with my life. Having had breast cancer, my options are limited for easing the symptoms. I can’t take HRT or some of the other medications on offer to menopausal women. However, with the help of many fabulous resources that I have come across (including the wonderful Hot Flush) and talking to lots of other women who are going through the same thing as myself (through my website Ticking Off Breast Cancer) I am gradually finding ways of managing some of the symptoms and I can see a glimmer of light at the end of the menopausal tunnel.
A quick note about breast cancer treatment and the menopause
I should point out that breast cancer treatment can differ from person to person because there are actually different types of breast cancer (which I did not know until I was diagnosed with breast cancer myself) and breast cancer is also treated differently depending upon the stage of the cancer (i.e. how long the tumour has been growing and how far it has spread, if at all). For those who need chemotherapy there are different chemotherapy drugs. Some chemo drugs can induce the menopause (because they affect the functioning of the ovaries). Confusingly, sometimes a chemo-induced menopause is a temporary menopause and even though periods cease and menopausal symptoms are experienced, periods can actually start up again once treatment has ended – because the ovaries can start functioning again. And then there are the treatments for hormone positive breast cancers (which essentially means that certain hormones encourage the tumour to grow). In the case of an oestrogen positive breast cancer (where oestrogen encourages tumour growth) patients are given hormone therapy to prevent the body producing oestrogen or to block the effect of oestrogen on breast cancer cells. As a result, these hormone therapies can also induce the menopause.
So, as you can see, there is no one answer to the question, “will breast cancer treatment put me into the menopause?” It depends on the type of breast cancer, the chemo drugs given, the type of hormone therapy (if any) and also upon the individual – some women can have identical treatment plans and yet one may go through the menopause and the other may not.