Some women facing cancer may experience premature menopause as a result of their treatment. Amanda Williams, Gynecologic Oncology Nurse Navigator at Sarah Cannon Cancer Institute at St. David's Healthcare, shares what women should know about premature menopause, including symptoms and tips to help cope with a changing body.
What is premature menopause, and how does it affect the body?
When premature menopause is prompted in the female body, it mean that there is a loss of ovarian function, resulting in lower estrogen levels. Estrogen not only assists with sexual reproduction health (including vaginal secretions, fertility and sex drive), but also bone and cardiac health and serotonin efficacy. Lower than normal levels can lead to poor sexual health through loss of sex drive or painful sex due to vaginal/vulvar atrophy or dryness. It also increases the risk for osteoporosis, heart disease and depression or mood swings.
What are the treatments that may cause premature menopause in some women?
Premature menopause may be a result of several different therapies. These include the surgical removal of the ovaries, damage to the genetic material of the ovaries through radiation (caused by ovarian absorption of high doses of radiation administered to the abdomen or pelvis), or chemotherapy through exposure to an ovotoxic agent.
What are the some of the common circumstances in which premature menopause might be permanent vs. temporary?
Having the ovaries removed will cause permanent menopause. Also, women over the age of 40 receiving chemotherapy or high dose abdominal/pelvic radiation have a greater chance of experiencing forced permanent menopause.
Temporary menopause can be caused by certain chemotherapies or drugs (such as anti-hormonals) that will interrupt ovarian function, but can return once treatment is completed. This chance is greater for women under the age of 40.
When should a woman discuss premature menopause with her doctor?
Women should be aware of any care plan that may impact her ovaries, and discussing premature menopause at the first office visit is important.
A consult with a fertility specialist may be recommended if she wishes to have children once treatment is completed. Also, a corresponding care plan needs to be established to address any other healthcare risks, such as adding calcium supplements for bone health, monitoring lipoprotein levels for cardiac health or addressing signs and symptoms of depression and mood swings.
What should women know in advance of their treatment?
Women should be aware of the typical menopausal symptoms and outcomes, and understand what needs to be reported to the doctor. Also, there are other correlating risks associated with menopause, such as osteoporosis and cardiac health, which women should be aware of.
Often patients will experience menopausal symptoms that are affecting their daily life significantly and think “Oh well, this is just the way it is” instead of contacting their physician for help.
Additionally, there are things that women can do to prepare to help lessen the symptoms of menopause. Practice good health habits, such as maintaining a nutritionally balanced diet, not smoking, exercising regularly and limiting alcohol intake. All of these factors combined promote a healthy environment in the body that assist with healing when experiencing changes such as menopause.
What are the most common symptoms of premature menopause?
Common side effects can include:
- Painful sex/decreased sexual desire
- Hot flashes
- Hair loss
- Weight gain
Extreme symptoms are those that impact quality of life negatively. This could include:
- Hot flashes that are consistently disruptive to sleep or require frequent breaks at work
- Insomnia that leads to fatigue or lethargy during the daytime
- Sexual health that is impacted by lack of desire or painful sex
Intensity in these symptoms will vary from patient to patient, but the common factor is how it is impacting their life.
Generally, women notice hot flashes, hair loss, weight gain and insomnia first. Symptoms such as fatigue or mood swings may go unnoticed as most women will attribute those to something else, such as working too hard or just being in a “bad mood.”
How can women cope with their changing bodies?
Here are five ways that women can help cope with the symptoms of menopause:
- It is important for women to keep a daily journal of menopausal symptoms, including their intensity and frequency. Most menopausal symptoms improve and resolve over time, and a journal helps monitor the progress. The journal also provides a guide to the physician on patient experience.
- Maintain a healthy lifestyle by eating a well-rounded diet, hydrating, exercising daily, avoiding alcohol/caffeine and not smoking.
- For hot flashes, wear loose/lightweight clothing preferably made with cotton and avoid warm temperatures. Keep instant cold packs (usually available at a local pharmacy or grocery store) close by, and place them behind the neck and in bilateral armpits when a hot flash starts.
- If a woman is experiencing insomnia, keep in mind that good sleep hygiene is essential! Go to bed at the same time every night, turn all electronics off one hour prior to bedtime, do not nap, and sleep in a dark, quiet and cool room. Add a melatonin supplement, if needed.
- For changes in sexual health, pelvic floor physical therapy and using a lubricant during sex can help with pain. Additionally, a sex therapist can help their patients recover their sexual health.