Menopause and Breast Cancer
Breast cancer treatment often causes women to enter menopause prematurely. The change in hormone levels and estrogen depletion caused by stopping hormone replacement therapy or undergoing chemotherapy or hormonal therapy can trigger side effects commonly associated with menopause.
Although each woman reacts to therapy individually, certain side effects are common. We hope this information will provide you with useful tips to help you manage any side effects that you may be experiencing.
Before implementing these management strategies, please discuss your specific symptoms with your physician or nurse and ask any questions you may have. If you are seeing a complementary or alternative medicine practitioner, please let us know what you are using so we can incorporate the information into your care plan.
Hot flashes are probably the most common side effect of menopause. Triggers include spicy foods, caffeine, alcohol, tight clothing, heat and stress. Try to avoid these things as best you can if your hot flashes are bothersome.
Foods, like soy products (soymilk, tofu, soynuts) and flaxseeds (either ground or in oil form) have been shown to reduce hot flashes in some women. Experiment with these in your diet if possible. We have helpful written materials on soy products and how to incorporate them into your diet.
Hot flashes tend to be worse at night, but a few simple things can make you more comfortable:
- Wear cotton pajamas and sleep with a fan on in a cool room
- Use cotton flannel or "T-shirt" sheets to absorb moisture
- Keep a change of sheets and pajamas close to your bed so that you can change them quickly if they are wet from perspiration
- Take a warm bath or shower before bed
The relaxation response, which includes deep abdominal breathing, has been shown to have many beneficial health effects, including minimizing hot flashes. It will help you stay calm and possibly avoid or reduce the severity of a hot flash. Try to take long, slow, deep breaths, seven to eight breaths per minute if possible, when you feel a hot flash coming on. Continue to do so for 15 minutes.
Daily exercise may also reduce hot flashes. Aerobic exercise for at least 20 to 30 minutes a day, at least three times a week is our recommendation. Aerobic exercise includes walking, running, swimming, biking or any other exercise that keeps your heart rate elevated for an extended time period.
We have an information sheet describing aerobic exercise that will be helpful for you. If you do not have a regular exercise program already, please consult with your physician or nurse to see what type of exercises may be best for you.
There are prescription medications that provide a benefit to some women. A current example is venlafaxine (Effexor). This medication is an antidepressant and in low doses, also can decrease the frequency and severity of hot flashes.
Hot flashes can interrupt a healthy night sleep, and insomnia is common. Some tips to help you avoid insomnia include:
- Only go to bed when you are tired.
- Only sleep while in bed. Do not read, eat or watch television.
- Get up at the same time every day despite not having had a good night's sleep.
- If you cannot fall asleep, do not stay in bed longer than 15 minutes, but instead get up, go into another room and only go back to bed when you are tired.
- Try to avoid sleeping pills if possible, but if necessary be sure to follow the directions.
- Avoid caffeinated foods like coffee, cola, and chocolate especially at nighttime.
- Avoid nicotine and alcohol especially at nighttime.
- Regular exercise is helpful.
A lack of estrogen and testosterone can cause many side effects that interfere with sexual desire and function. A decreased libido (or sex drive) is common and many authors say this may be related to decreases in estrogen and testosterone levels.
Vaginal dryness often causes discomfort and irritation, vaginal discharge or infection and pain during sexual intercourse. Try using a non-prescription, water-based vaginal lubricant like Astroglide or K-Y Jelly to reduce pain during intercourse. Oil-based lubricants like Vaseline are not recommended. Over the counter products with scents, alcohol or other additives should also be avoided. Replens is a vaginal moisturizer that can help with dryness as well.
Talk with your doctor or nurse if you have questions about how to use these products. You may want to discuss products requiring a prescription — for example a topical ointment containing low dose testosterone or very low dose estrogen products — with your physician as well.
We have an informative sheet on "Sexuality and Cancer" which is a good resource. The booklet "Sexuality and Cancer: For the Woman Who Has Cancer and Her Partner," by the American Cancer Society, is an excellent source of information as well.
Anxiety and Mood Changes
Exercise, again, will help to stabilize your mood changes and reduce anxiety. If you have difficulty doing 20 to 30 minutes of aerobic exercise, three times a week, then begin with what you are comfortable with and try to increase your exercise program when you are ready.
Invoking the relaxation response by using deep abdominal breathing will also help you to relax, reduce anxiety and stabilize mood changes.
Talking with a professional also is recommended.
Difficulty with memory is common in mid-life, but especially during menopause. Tools to help you compensate for any memory challenges you may be experiencing include:
- Making to-do lists
- Keeping a detailed calendar
- Having designated places for important things like keys, wallets and glasses
- Leaving a reminder at your door to check the stove and other appliances to make sure they are turned off
- Maintaining good nutrition and hydration
- Keeping your brain active by reading and conversing with others
Osteoporosis is a risk for all women as they age. However, women with breast cancer must be especially cautious, because most doctors advise they avoid taking additional hormones that help prevent osteoporosis.
Certain drugs like alendronate (Fosamax), calcitonin and raloxifene (Evista) can help increase calcium levels. These drugs might be appropriate for you, but should be discussed with your physician. Finally, maintaining a healthy diet and getting regular exercise helps prevent fractures and maintain bone strength.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
Basic Facts About Breast Health
Learn basic facts about breast structure and function and how to differentiate between the different types and stages of breast cancer.
Breast Cancer Glossary
Check out our comprehensive Glossary of Breast Cancer terminology, which includes definitions of everything from AC chemotherapy to peripheral neuropathy.
Breast Cancer Risk Factors
Click now to find a summary of the factors that increase risk for developing breast cancer, including both factors that we cannot change and those we can.
Self-Care and Recovery
Self-Care and recovery resources including an Introduction to Lifestyle Change, Nutrition and Breast Cancer, Hydration: Water and Health, Meditation and more.
Breast reconstruction, surgery to rebuild a breast's shape, is often an option after mastectomy and is covered by some health insurance plans. Learn more now.
Follow-Up Care for Breast Cancer Patients
After patients have completed treatment for early stage breast cancer, one of the common questions is, "How should I best be monitored?" Learn more here.
Mastectomy: Instructions Before Surgery
The following information will help you prepare for your upcoming Mastectomy surgery. If you have any questions, please contact the Breast Care Center staff.
Mastectomy: Instructions After Surgery
Post Mastectomy surgery instructions including, pain management, incision and dressing care, activity, diet, follow-up care and more.
Metastatic Breast Cancer: Diagnosis and Treatment
Metastatic breast cancer is cancer that originated in the breast and has spread to other organ systems in the body. Learn more here.
Navigating Your Path to Breast Care
Different services and information are needed at different points in breast health care and breast cancer treatment. Learn more here.
Osteoporosis and Breast Cancer
Women who have had breast cancer or are considered at high risk for developing breast cancer are at risk for developing osteoporosis. Learn more.
Radiation Therapy for Breast Cancer
The UCSF Carol Franc Buck Breast Care Center and the Department of Radiation Oncology have compiled information about radiation therapy for your convenience.
Knowledge may lead you to take action to protect your health and that of other women you care about: your mother, daughters, relatives and friends. Learn more.