The ovaries produce the hormones oestrogen and progesterone. If you’ve had a hysterectomy and both ovaries have been removed, or if you’ve had radiotherapy in the pelvic area, your ovaries will no longer produce these hormones. If you are not already menopausal, this will cause sudden menopause.
Chemotherapy may also cause your periods to stop, either temporarily or permanently.
The usual age for menopause is between 45 and 55. The loss of menstruation and fertility at a younger age can lead to feelings of sadness, grief and low self-esteem. You may feel old before your time or less feminine.
When menopause is brought on by cancer treatment, the symptoms are usually more severe than a natural menopause because the body hasn’t had time to get used to the gradual decrease in hormone levels. You may experience hot flushes, mood swings, trouble sleeping and tiredness. The vagina can also lose elasticity and become dry, because it needs oestrogen to stay moist.
You can manage menopausal symptoms in several ways:
- Hormone replacement therapy (HRT) can help reduce your symptoms. Using HRT for more than five years increases the risk of some diseases including breast cancer, but it also decreases the risk of other diseases. You will need to talk to your gynaecologic oncologist about the benefits and risks of HRT. If you were already on HRT when your cancer was diagnosed, you will need to weigh up the risks of continuing it. Because vaginal cancer can be hormone-sensitive, HRT may not be suitable for some women.
- Locally applied oestrogen, contained in creams or pessaries, can be inserted into the vagina to relieve dryness. Vaginal moisturisers without oestrogen can also be used.
- To relieve hot flushes, try wearing cotton clothing and using cotton sheets, and dressing in layers that you can take off if you get warm. Sleep in a cool room to avoid being awakened by a hot flush. Limit your intake of alcohol, caffeine and spicy foods.
- There are a number of dietary, herbal and alternative approaches to managing menopausal symptoms, such as herbal remedies and changes to your diet. Talk to your doctor or health care team for more information.
No matter what you decide to do, you should advise your doctors about how you are managing your menopausal symptoms.
Menopause may cause bones to weaken and break more easily. This is called osteoporosis.
You may be able to prevent osteoporosis by:
- getting your daily recommended amounts of calcium and vitamin D
- engaging in regular weight-bearing exercise
- avoiding smoking and excessive alcohol.
Talk to your healthcare provider about osteoporosis. You may have a bone density test or be prescribed medication to prevent your bones from becoming weak and brittle. You can also call Osteoporosis Australia on (02) 9518 8140 or visit their website at www.osteoporosis.org.au
After menopause, changes in your cholesterol balance increase your risk of hardening and blockage of the arteries.
If you smoke, quitting is probably the most important thing you can do to either prevent heart disease or to prevent further problems if you already have heart disease.
There are many other positive lifestyle changes you can make at menopause that will reduce your risk of heart disease and stroke. You can try to maintain a healthy weight by eating a balanced diet with lower fat levels, exercising regularly and reducing your stress levels. If necessary, your doctor may prescribe medications to reduce your risk, such as cholesterol-lowering drugs.