Reduce menopause symptoms from breast cancer treatment

Many treatments used in breast cancer and metastatic breast cancer can cause symptoms of menopause.

The symptoms and their severity are different from person to person.

If you do have signs of menopause, it’s important to know they are normal and there are ways to reduce their impact on your life.

Hot flushes and night sweats

Hot flushes are the most common menopausal symptom with hormone-blocking treatment.

They may be worse at night and disturb your sleep, leaving you feeling tired and irritable.

What you can try

• Wear loose clothes made from natural fibres such as cotton or bamboo, and layers you can take off when you feel hot.
• Use an electric or handheld fan to lower your skin temperature.
• Use cotton bedsheets instead of synthetic sheets.
• Take a cool/lukewarm shower or bath before bed.
• Avoid stuffy rooms and hot environments when you can.
• Use water sprays or moist towels to help lower your skin temperature.
• Drink cold water to lower your body temperature.
• Wear a sports 'ice' towel, available from chemists, around your neck to help relieve night sweats.
• Exercise regularly, aiming for 30 minutes most days.
• Try mindfulness, meditation, yoga or other relaxation techniques.
• Aim to maintain your ideal weight.
• Avoid foods and fluids that may cause hot flushes, such as spicy food, alcohol, coffee and other drinks with caffeine.
• Minimise stress if you can. Feeling overwhelmed and anxious may trigger hot flushes. Stop every so often to take a deep breath, to help you relax.
• Have cognitive behavioural therapy (CBT) with a qualified health professional. This can be very effective but can also be expensive and hard to access. Read Psychology and counselling support.
• Try acupuncture - find an acupuncture practitioner who is a member of the Australian Acupuncture and Chinese Medicine Association.

If none of these ideas work, and hot flushes are affecting your quality of life, talk to your specialist about medication.

All medications have side effects and some may interact with other drugs you might be taking so it’s important to check this with your treating team.

Medications that can help with hot flushes include:

• low-dose antidepressants such as venlafaxine (Effexor) and desvenlafaxine (Pristiq), fluoxetine (Prozac), escitalopram (Lexapro), citalopram (Celaxa).
• medication normally used to treat chronic pain such as gabapentin (Neurontin). It is best to take the medicine before you go to bed at night. Hot flushes often occur in the first few hours of sleep, and gabapentin can be a sedative, so this helps avoid brain fog and drowsiness during the day.
• oxybutynin (Ditropan) is usually used to treat bladder incontinence but can reduce the number and severity of hot flushes and night sweats. It does have several side effects so talk to your specialist.
• fezolinetant. This newly registered medication has been proven to effectively reduce hot flushes with very few side effects. It is not currently PBS listed and costs around $60 per month.

Complementary medicines for hot flushes

Check with your doctor before taking any herbal supplements such as black cohosh. It is not clear how many complementary products work, if at all. They may interact with medications you are taking, such as tamoxifen. 

Tiredness and fatigue

Fatigue and tiredness are common side effects of hormone-blocking treatment.

Find out about:

• Fatigue and breast cancer treatments – signs, causes and tips to help
• Sleep problems – what can cause issues and what you can do

If sleeplessness ('insomnia') is affecting your quality of life, speak to your oncologist, nurse or GP for advice and options.

Weight gain

Putting on weight, especially around the abdomen, is very common during menopause.

Breast cancer treatment can lower your levels of oestrogen and progesterone. This can change your body's composition to more fat and less muscle. It also slows your metabolic rate.

These factors make it harder to burn calories and therefore many people put on weight.

Keeping a healthy weight is important to:

• reduce your risk of a breast cancer recurrence
• reduce your risk of developing lymphoedema
• keep your bones and heart healthy.

There are many ways you can minimise or reverse weight gain and improve your overall health and wellbeing.

Read Physical activity, healthy eating and breast cancer.

Vaginal changes

Hormone-blocking treatments reduce oestrogen, which is important for vaginal health. Some women experience vaginal dryness and tightness as a side effect of treatment. Don’t be embarrassed talking to your treating team about this issue – it’s very common, and they will have plenty of things for you to try. 

Find out more at Vaginal changes.

Lower libido

Breast cancer and its treatments can affect your sexual health wellbeing and sexual desire. Loss of desire can be a complex problem.

The problem can be both biological and psychological:

• Hormone-blocking therapy can lower oestrogen or progesterone levels, and this can lead to low libido.
• Stress, anxiety and depression, as well as low self-esteem and poor body image, can also contribute to loss of desire.

What you can try

• If you have a partner, talking openly with them about how you are feeling can help. If you decide you aren’t ready for sex, there are other ways to be affectionate and intimate.
• Be open about your needs. If what you need is a cuddle or a massage, but not sex, tell your partner that.
• Although it's a difficult subject to raise, it can help to talk to a health professional such as your GP or breast care nurse. They will be able offer some advice or refer you to someone else who can help.
• Our Online Network is a safe and supportive place where you can ask questions and see what others have experienced.
• For information, read Sexual wellbeing and intimacy.
• ConnectAble Therapies has information and articles on intimacy, sex and cancer for people during and after cancer treatments. 

Mood changes

A diagnosis of cancer is difficult, even without hormonal changes affecting your mood. Your moods may change, day to day. It’s a common symptom of menopause to feel irritable one day, positive and happy the next, and sad on yet another day. This is normal.

It’s important you discuss your symptoms with your doctor or breast care nurse to exclude underlying depression if:

• your moods are constantly low
• you find you’re losing interest in activities that you usually enjoy
• you have less energy or difficulty sleeping
• anxiety is an ongoing feeling.

Find out about:

• Anxiety, depression and ways to reduce them
• Emotional wellbeing and tips to look after yourself

Poor memory and concentration

Difficulties with concentration and memory can be very frustrating and hard to cope with.

Read about Brain fog or cognitive impairment – signs and tips to help.

Joint and muscle pain

Joint pain can be a difficult side effect of treatment. Hormone-blocking therapy, particularly the aromatase inhibitors, can cause discomfort.

For ways to reduce the impact, go to Joint pain related to hormone-blocking treatments.

Leg cramps

Leg cramps are most common in the calf muscle, due to an involuntary spasm. They can be very painful, and you may temporarily be unable to use your leg. They tend to happen when you are falling asleep or just waking up.

The following suggestions may help to ease leg cramps:

• Walk around. This may stretch the muscle and help stop it contracting.
• Massage the muscle to help relieve spasming.
• Use a cold pack on the muscle to ease the pain.
• Relax the muscles by taking a hot bath.
• Straighten your leg and flex your foot back toward your body to stretch the calf muscle.

Ways to prevent leg cramps

• Drink plenty of water during the day to stay hydrated.
• Stretch your leg muscles before going to bed.
• Eat plenty of potassium-rich foods, such as bananas, avocado, plain yoghurt and dried apricots.
• Ask your GP, oncologist or nurse about magnesium tablets or powder. These can help, but you need to be sure the supplements are safe while you are taking other medications.