How to cope with early menopause
Published: 28th May 2020
Cancer and its treatments will undoubtedly cause many changes in your life. One change you might not have anticipated at the outset is going through the menopause early.
If you have a gynaecological cancer (womb, ovarian, cervical, vaginal or vulval), certain types of chemotherapy, radiotherapy or surgery may bring on symptoms of the menopause and it can happen quite suddenly. There are also some types of drugs used for the treatment of breast cancer that block the action of hormones working and bring on menopausal symptoms while you are taking the treatment.
An early menopause can be distressing and make you feel overwhelmed, isolated or confused about the changes happening to your body.
The good news is - for most women - there are very effective menopause ways available to help you live well, after cancer. This is why it is so important to find out about an early menopause, ask for support when you need it and get the right help as soon as possible.
Here are my top 10 tips for staying ahead of the menopause:
1. Learn about what might happen and why
If you know your cancer treatment might cause an early menopause, it is worth taking the time to find out how it might affect you and what the treatments are.
‘Forewarned is forearmed’, as the saying goes, so read up about early menopause. ‘Surgical menopause’, ‘premature ovarian insufficiency’ or ‘POI’ can also be useful search terms.
2. Be on the lookout for menopause symptoms
The severity of symptoms varies tremendously between women; they may come on very suddenly after surgery and be noticeable straight away, for other women, maybe after chemotherapy, it might be a gradual change that you won’t initially realise is related to an early menopause.
Common symptoms of the menopause include:
Changes to your periods (in frequency or flow, or them stopping altogether), hot flushes, night sweats, mood changes (especially if you’ve had PMS in the past), fatigue and poor sleep, difficulty concentrating, loss of interest in sex, joint pains and muscle aches, dry or itchy skin, headaches (or worsening migraines if you already suffer with them), needing to wee more often or having leaks of urine when you cough or sneeze, urine infections or thrush, and dryness and soreness in and around your vagina.
Symptoms can really vary between different women. Some women experience very few symptoms whereas others experience many symptoms that can have a very negative effect on the quality of their lives.
3. Keep a note of your symptoms
A really useful idea is to start logging symptoms as they occur. There are several ways you can do this, keep a diary, use a period tracker app, or fill in a form called the ‘Greene Climacteric Scale’ (available on my website) and take that with you to your doctor.
Keeping track of your symptoms will also be really useful if you start any treatments for the menopause - to see if it’s working for you.
4. See a doctor that specialises in the menopause
You may feel as though you see enough medical professionals already and the thought of another set of appointments will put you off this idea, however getting the right treatments for your menopausal symptoms is essential to feeling the best you can.
The main hormones your body will not be producing inadequate levels are estrogen and progestogen. Treatment involves replacing these with ‘body identical’ versions in the form of HRT for many women. Making sure you are on the right type and dose of HRT can sometimes need a specialist.
You may also benefit from taking testosterone, particularly if you’re struggling with low energy, mental fatigue and a lack of interest in sex.
There are alternatives to HRT for women who often cannot take HRT due to the type of cancer they have had. These can be discussed by a doctor who specialises in the menopause.
5. Be open with family and friends and use them for support
If treatments for your cancer have finished and things have calmed down on that front, family and friends may think you’re through the worst and attention can move on to other things. You, meanwhile, maybe just at the start of another challenge. Some women find coping with their menopausal symptoms harder than going through the cancer treatments.
Sometimes you can feel as if you’re going mad for example if your mood changes suddenly or you start forgetting simple things. Don’t worry, it’s usually just your hormones and it’s so common for women going through the menopause to feel exactly like that.
6. Get treatment for menopausal symptoms, sooner rather than later
Hopefully, if your doctor knows your surgery, chemo, or radiotherapy is likely to cause an early menopause, she or he will already talk to you about replacing the lost hormones you will need and will mention HRT (hormone replacement therapy) early on in the process.
It’s not a great idea to resist or put off taking HRT if it has been suggested to you by your doctor. Symptoms can come on very suddenly and the earlier HRT is started the better you will feel.
If you had a hormone-sensitive (hormone-dependent) type of breast or uterine cancer you may not be able to take HRT but check this out thoroughly with a specialist and see what else you can do to improve symptoms.
7. Persevere with getting the right treatment and stay on it for as long as you feel it’s needed
HRT will normally be recommended until you are at the age of a natural menopause, which is 51 years. It is understandable that you might not be keen to be on medication for so many years if you are still in your 20’s or 30’s. Many women continue to take HRT forever.
What the replacement hormones are doing is – as well as keeping away symptoms that can impact negatively on your life – they are protecting your health and preventing long-term consequences of a lack of estrogen and progestogen. Without HRT, you will be at risk of your bones becoming weak and developing osteoporosis; you are also at risk of heart disease.
8. Look after yourself
it is important to try and have a lifestyle that will help not hinder your menopause.
There are lots of tips on my website to help you do this, but the basics are:
- Eat a healthy, balanced diet rich in vitamins and minerals, especially calcium.
- Exercise regularly, if you are able.
- Limit alcohol and cigarettes - alcohol can interrupt sleep and exacerbate hot flushes. If you smoke, try to cut down with the aim of quitting altogether.
- Get enough vitamin D to help protect your bones and lift your mood - you may want to take it as a supplement.
- Relax - where possible take time out for yourself and do something you enjoy that lifts your mood
9. Look after your relationships
Even the closest bonds can be tested to their limits during the menopause. Hormones can wreak havoc, leaving us angry one minute and tearful the next. Talking about how you’re both feeling is the single most effective way to getting through it together.
There may be times when you don’t feel like talking or being around others, so don’t be afraid to make that space for yourself and explain why.
10. Be proactive about how it affects you at work
You may have already returned to work when the menopausal symptoms start having an unwanted effect on you. Try and talk to your line manager and ask for a meeting to discuss your health and implications for work.
There are loads of things you can do to combat menopausal symptoms at work from looking at the set up of your work environment, ways to plan your day, taking 3-minute stress buster time-outs, using memory aids and so on.
Newson Health Menopause and Wellbeing Centre was launched in 2018 by leading menopause specialist and GP, Dr Louise Newson. Created to help women receive the most appropriate, individualised and holistic treatment for their perimenopause and menopause, it has quickly become a centre of excellence, providing care to women of all ages, both via remote consultations and in-person at clinics in Stratford-upon-Avon, Warwickshire and Lymm, Cheshire.
A passionate and tireless campaigner for better menopause care for all women, Dr Newson has also founded the Menopause Doctor website, The Menopause Charity, the balance app, Newson Health Research and Education and written a best-selling Haynes Manual on Menopause.
The Menopause Doctor website is a free resource providing a huge amount of unbiased, evidence based information about the menopause and perimenopause for women and healthcare professionals. The site has been adopted by the Royal College of GPs (RCGP) as an official educational library for menopause. Visit www.menopausedoctor.co.uk.
The Menopause Charity was founded in 2020, with trustees including sustainable health expert Professor Matthew Cripps and media ambassadors Davina McCall, Lorraine Kelly, Liz Earle and Meg Mathews. The charity has many exciting plans to help women and their families and colleagues with the challenges caused by the menopause, including an educational website, professionally staffed helpline and fundraising for research activities. Visit www.themenopausecharity.org.
‘balance’ is a free app that was developed to enable women to track their symptoms, access personalised expert content, share stories and lots more. Get the balance app at www.balance-app.com.
Newson Health Research and Education is a not-for-profit organisation from which all profits are invested back into the business. A Confidence in Menopause educational platform has been developed specifically for healthcare professionals and can be found at https://www.fourteenfish.com/menopause/subscribe
The Haynes Manual on Menopause is a definitive guide to help women, their partners and families cut through the plethora of misinformation and take a straightforward look at menopause. Find out more at www.newsonhealth.co.uk/resources/menopause-manual.