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Some of the treatments for breast cancer, including chemotherapy and hormonal therapy, can affect the function of the ovaries or the level of hormones in the body. As a result, you may begin your menopause earlier than expected, or have menopausal symptoms due to the treatment itself.
The change in hormone levels can cause a number of symptoms. These can include:
Women may have one or more of these symptoms, and symptoms can range from being very mild to more severe. There are different ways of controlling these symptoms| . Some women find complementary therapies| helpful.
Menopause, particularly if it occurs early in life, may cause other effects| on the body, such as thinning of the bones (osteoporosis) and heart disease. These effects develop at different rates in different people. Their tendency to develop is, at least partly, passed on from your parents (genetically determined).
Women who have had breast cancer are usually advised not to take hormone replacement therapy. However, if you have troublesome menopausal symptoms, medicines can be used to treat them.
Below you'll learn about the different treatments that can cause an early menopause or menopausal symptoms and why.
Women naturally stop having regular periods, usually at some time between their mid-40s and mid-50s. The menopause, or change of life, happens because the ovaries stop producing the sex hormones oestrogen and progesterone .
The following breast cancer treatments also can affect the levels of these hormones in the body:
Women who develop breast cancer at a young age may be advised to have treatment to stop their ovaries producing oestrogen| , as oestrogen could stimulate the growth of breast cancer cells. The ovaries can be permanently stopped from producing oestrogen, using surgery or radiotherapy:
Some chemotherapy | drugs will stop the ovaries from working. This can be temporary, but the nearer you are to your natural menopausal age, the more likely it is to be permanent. If it is permanent, the treatment will bring on the menopause and you may develop some of the symptoms described earlier. Even if the treatment does not cause an immediate menopause, it may prompt the menopause start earlier than it would otherwise have done.
It is not possible to predict before your treatment whether the chemotherapy will affect you temporarily or permanently. Your periods could return to normal in time, so you could still get pregnant and should use contraception after your chemotherapy has ended.
Because the sex hormones oestrogen and progesterone can affect the growth of breast cancer cells, treatments for breast cancer often involve hormonal therapy| that blocks oestrogen from getting to breast cancer cells, or reduces the level of oestrogen in the body. These treatments may cause an early menopause or menopausal symptoms.
The two main types of hormonal therapy used to treat breast cancer are:
As with chemotherapy, the nearer you are to your natural menopausal age, the more likely it is that hormonal therapy will bring on an early menopause, and that your periods will not start again when treatment has ended. Women who have already had their menopause may have menopausal symptoms again when they begin hormonal therapy.
LHRH analogues such as goserelin (Zoladex®) | , stop the ovaries from producing oestrogen altogether, but unlike surgery or radiotherapy, this is reversible. These drugs cause menopausal symptoms while you are taking them. However, your periods usually start again when treatment is stopped.
Women who are close to their natural menopause when they start treatment may find that their periods do not begin again after treatment.
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