If you still have your reproductive organs, you may be able to conceive after cancer treatment without medical assistance. However, about one in three women will experience one of the following physical issues.
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Acute ovarian failure
During treatment, and for some time afterwards, the ovaries often stop producing hormones because of the damage caused by the cancer treatment. This is known as acute or temporary ovarian failure. You will have occasional or no periods, and symptoms similar to menopause (see below), before regular periods return. If ovarian failure continues for several years, it is less likely that your ovaries will work normally again.
Early menopause
Menopause before the age of 40 is known as premature ovarian insufficiency (POI). This is when you stop having menstrual periods because egg numbers are very low. It may also be called early or premature menopause.
POI could occur immediately or many years after treatment depending on your age, type of treatment and the dose of any drugs you received. If the ovaries are surgically removed or too many eggs are damaged during treatment, menopause is permanent.
While menopause means you won’t ovulate, it is still possible to carry a baby if you have a uterus and use stored eggs or donor eggs. A small number of women with POI (5–10%) have a chance of becoming pregnant naturally, because in some rare cases, a remaining egg may mature and be fertilised by a sperm.
Most menopause symptoms are related to a drop in your body’s oestrogen levels. Menopause symptoms are usually more severe when menopause starts suddenly, because the body hasn’t had time to get used to the gradual decrease in hormone levels.
Symptoms may include:
- a dry or tight vagina
- a decreased interest in sex (low libido)
- hot flushes and night sweats
- aching joints
- trouble sleeping
- dry or itchy skin
- feeling more anxious or overwhelmed.
Some ways to manage menopause symptoms are listed below. For more information, talk to your doctor or ask for a referral to a specialist menopause clinic.
It feels like menopause is discussed as a treatment side effect, not as this massive impact on who you are as a person. I’m facing menopause 20 years earlier than my friends.
Denise
Osteoporosis
Early menopause can cause the bones to weaken (osteoporosis). Talk to your doctor about having a bone density test or taking medicines to prevent your bones weakening.
Regular weight-bearing exercise will help keep your bones strong. Osteoporosis Australia has more information.
Hot flushes, dry vagina and poor sleep
Menopause hormone therapy (MHT, previously known as hormone replacement therapy or HRT) may help treat these symptoms. MHT replaces the hormones usually produced by the ovaries, and can be taken as tablets, creams or skin patches. Taking MHT may increase the risk of some diseases.
Some women with a hormone-sensitive cancer may be advised not to take MHT, but there are other non-hormonal drugs available that can help. Vaginal moisturisers available over the counter can also help with vaginal discomfort and dryness.
Anxiety
Meditation and relaxation techniques can help reduce stress and lessen anxiety. Cognitive behaviour therapy (CBT) has been shown to be effective in helping women deal with many of the effects of menopause, including anxiety. Exercise can also help with mood changes and energy levels.
For more on this, see Emotions and cancer and Complementary therapies.
Your feelings about early menopause
When cancer treatment causes early menopause, the impact on your emotions, body image and relationships can be significant.
If you are younger, experiencing menopause much earlier than expected may affect your sense of identity, or make you feel older than your age or friends. You may feel less feminine and worry that you are less attractive.
If you are older, going through menopause earlier than expected may be upsetting. But some older women say they feel relieved not having to worry about regular periods.
You may find it difficult to start new intimate relationships after going through menopause.
It may take time to accept the changes you’re experiencing. Talking to a family member, friend or counsellor may help.
Listen to our podcasts on Making Treatment Decisions, Sex and Cancer and Coping with a Cancer Diagnosis
Additional resources
Dr Ying Li, Gynaecologist and Fertility Specialist, RPA Fertility Unit, Royal Prince Alfred Hospital, NSW; Dr Antoinette Anazodo, Paediatric and Adolescent Oncologist, Sydney Children’s Hospital and Prince of Wales Hospital, NSW, and Lead Clinician for Youth Cancer NSW/ACT; Paul Baden, Consumer; Dawn Bedwell, 13 11 20 Consultant, Cancer Council Queensland; Maurice Edwards, Special Counsel, Watts McCray Lawyers, NSW; Helena Green, Clinical Sexologist and Counsellor, InSync for Life, WA; Dr Michelle Peate, Program Leader, Psychosocial Health and Wellbeing Research (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women’s Hospital, The University of Melbourne, VIC; A/Prof Kate Stern, Gynaecologist and Reproductive Endocrinologist and Head, Fertility Preservation Service, Royal Women’s Hospital Melbourne, The University of Melbourne, VIC; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Resea ch Institute (THRI), School of Medicine, Western Sydney University, NSW; Renee Van Den Bosch, Consumer.
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