Reducing complications caused by an early menopause

An early menopause can increase your risk of bone thinning (osteoporosis) and heart disease.

There are some things you can do to help reduce your risk of bone thinning, such as:

  • regular, weight-bearing exercise, like walking or gentle weight-lifting
  • getting enough calcium and vitamin D in your diet
  • some medicines.

Your doctor will be able to tell you if any medicines are suitable.

If you already have osteoporosis, avoid exercise that puts strain on your bones.

To reduce your risk of heart disease, try to follow this advice:

  • If you smoke, stop smoking.
  • Eat a healthy diet. Try to eat less animal fat, and include more fresh fruit and vegetables.
  • Do regular exercise.

Talk to your GP or doctor if you’re worried about a family history of heart disease. They will be able to advise you about medicines that may help to prevent it.

Bone thinning (osteoporosis)

Oestrogen helps maintain bone calcium levels and bone density. The risk of osteoporosis is higher after the menopause.

Exercise

Regular weight-bearing exercises will help maintain bone density. You could try:

  • walking
  • dancing
  • hiking
  • gentle weight-lifting.

Swimming isn’t as helpful, because your bones aren’t supporting your weight while you swim.

If you already have osteoporosis, avoid exercises that put strain on your bones, such as jogging. A physiotherapist or your breast care nurse can give you further advice about exercise after breast cancer.

Diet

It’s important to make sure that you get enough calcium and vitamin D in your diet. Vitamin D helps the body use calcium effectively. Dairy products are the best source of calcium, but if you prefer not to eat them you can get calcium from:

  • eggs
  • green leafy vegetables
  • nuts
  • whole fish such as whitebait, sardines and pilchards.

A well-balanced diet will normally give you all the calcium and vitamin D you need, but calcium and vitamin D supplements may also be helpful. Talk to your specialist if you think supplements would be useful.

Smoking and drinking alcohol can reduce your calcium levels. Stick to sensible drinking guidelines, and if you smoke, the healthiest option is to give up.

Medicines

If other people in your family have had osteoporosis, you may want to talk to your cancer specialist about drugs called bisphosphonates. These can help prevent osteoporosis.

Tamoxifen, a hormonal drug commonly used to treat breast cancer, may help to protect the bones in postmenopausal women. A drug called raloxifene (Evista®) can also help prevent osteoporosis.

However, aromatase inhibitors such as anastrozole, letrozole and exemestane, which are also commonly used to treat breast cancer, can increase the risk of osteoporosis.

National guidelines recommend women have their bone health (density) checked by having a special bone scan called a DEXA scan before treatment with an aromatase inhibitor. Depending on the results, you may be prescribed bone-strengthening drugs (called bisphosphonates) to minimise the risk of problems. Your bone health can be monitored during and after treatment.

The National Osteoporosis Society can give you more information about prevention of osteoporosis and helpful treatments.


Heart disease

The risk of heart disease in women increases after the menopause. Research also suggests that aromatase inhibitors, such as anastrozole, letrozole and exemestane, may also slightly increase the risk compared to taking tamoxifen. However, for most women, the benefit of taking an aromatase inhibitor will outweigh any increased risk of developing heart disease. Talk to your specialist if you are concerned about your risk of heart disease.

It is a good idea to follow the well-established advice on reducing your risks: 

  • If you smoke, stopping smoking is the healthiest decision you can make. 
  • Eat less animal fat (especially red meat), choose low-fat dairy products and eat more fresh fruit and vegetables. 
  • Take regular exercise

If there’s heart disease in your family, you may wish to talk to your cancer specialist or GP about using medicines to try to prevent it.

Back to Menopausal symptoms

What are menopausal symptoms?

Some breast cancer treatments may cause an early or temporary menopause, or side effects similar to menopausal symptoms.

Managing menopausal symptoms

There are different ways of managing and reducing menopausal symptoms. Your breast care nurse can give you advice about this.