Menopausal symptoms

Breast cancer treatments such as chemotherapy, hormone (endocrine) therapy or ovarian ablation or suppression (stopping the ovaries working either permanently or temporarily) can cause menopausal symptoms throughout and beyond treatment. These are generally temporary but may be permanent. The symptoms are often more intense than when menopause occurs naturally.

Common syptoms

Some of the more common menopausal symptoms include:

• hot flushes
• night sweats
• mood changes
• joint aches and pains
• vaginal dryness
• decreased sex drive
• palpitations
• weight gain.

Hot flushes

For many women, hot flushes and other menopausal symptoms can affect how they feel on a day-to-day basis. The following tips have been recommended by other women to help cope with hot flushes and night sweats.

• Wear cotton or silk clothing.
• Wear layers of clothing that can be taken off or put on as needed.
• Put a cool pack under your pillow so that you can turn the pillow over in the night. Some patients have suggested using a cool pillow known as a ‘chillow’. Visit www.chillow.co.uk for more information.
• Water sprays or moist wipes will help to lower the skin temperature.
• Use an electric fan.
• If you are not sleeping well at night, try to find time to rest in the day.
• Regular gentle exercise such as going for a walk may help to reduce symptoms.
• If you are a smoker, try to stop smoking or cut down.
• If you are taking tamoxifen it may help to split the dose (10mgs in the morning and 10mgs at night).

Relaxation

Many women find that reducing stress makes their symptoms less severe. This might just mean learning to become calmer - which may be achieved by using controlled breathing techniques - or might involve doing things to reduce stress, such as relaxation, increasing rest time or decreasing work demands if possible.

Complementary therapies

Some women may find complementary therapies help with relaxation and relieve hot flushes. There are many to choose from and although there is limited evidence to support their use, many people find them helpful. They include homeopathy, acupuncture, reflexology, massage, aromatherapy, hypnotherapy and meditation.

Diet

Food can be one of the triggers for hot flushes and some women find that specific things, such as spicy foods, caffeine or alcohol, have this effect. You will need to work out what your triggers are. Some women find that eating frequent small meals rather than larger ones is helpful. If you are overweight, losing weight may reduce your symptoms.

Herbal medicine and phytoestrogens (plant oestrogens)

If you are thinking about using herbal remedies and/or phytoestrogens, it is very important that you talk to your specialist or breast care nurse and consult with a suitably qualified practitioner.

Phytoestrogens are chemicals found in plant foods. There is a variety of them, all with different actions, although in general they mimic the effect of oestrogen in the body. It is unclear if they help to reduce hot flushes. Phytoestrogens are found in many fruits, vegetables and grains. There has been a lot of research to examine the use of soy proteins and other phytoestrogens to relieve hot flushes, but the results are inconsistent regarding their safety and effectiveness.

It is currently uncertain what effect phytoestrogens have on the body when they are taken in greater amounts than found in a normal diet. It is also not clear whether the amount of plant oestrogen in your body has any effect on the risk of your cancer coming back.

Not recommended

The National Institute for Health and Clinical Excellence (NICE) is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health. NICE does not recommend soy (isoflavones), red clover, black cohosh or vitamin E for the treatment of menopausal symptoms in women with breast cancer.

It has also been suggested that the herbs St John's wort and ginseng may interact with the conventional medical drug tamoxifen, causing it to be less effective. For more information on herbal remedies see our Complementary therapies booklet and Menopausal symptoms and breast cancer factsheet.

More information

Menopausal symptoms vary from one person to another. However many women find these symptoms difficult to cope with, in addition to the experience of breast cancer itself. If you find you are unable to cope or that you are feeling down, try talking with your GP or breast care nurse.