Recommendations for the management of menopausal symptoms in women with breast cancer

Researchers have reviewed the evidence on early menopause in breast cancer patients and have come up with a series of recommendations to safely manage this side-effect.

The recommendations are published in The Journal of Clinical Endocrinology and Metabolism and are the result of a review of a number of clinical trials, observational studies and guidelines.

Chemotherapy treatment can often result in early menopause for women with breast cancer, while hormone therapy, such as tamoxifen and aromatase inhibitors, can also result in early menopause or make menopausal symptoms worse.

Menopausal symptoms can include:

  • Hot flushes
  • Vaginal dryness
  • Night sweats
  • Mood changes
  • Osteoporosis.

The researchers say these symptoms can have a dramatic effect on women’s lives and treatment of these symptoms needs to be individualised based on the woman concerned.

However, they are clear that women who have been treated for breast cancer should not pursue the option of Hormone Replacement Therapy (HRT).

Research has shown that HRT increases the risk of breast cancer in women who have not been diagnosed and increases the risk of recurrence in women who have been diagnosed with the disease.

They say, “Following breast cancer, women should not generally be treated with menopausal hormone therapy but should optimise lifestyle.

“A variety of non-hormone options and therapies are available for the treatment of estrogen–depletion symptoms and clinical problems after a diagnosis of breast cancer.”

The researchers outline key options women should consider for the management of menopausal symptoms after breast cancer treatment. These include:

  • Using anti-depressants
  • Stopping smoking
  • Losing weight
  • Limiting or avoiding alcohol
  • Getting the recommended amounts of vitamin D and calcium
  • Exercising regularly
  • Eating a diet rich in unprocessed foods and vegetables and low in processed foods and foods with added sugar and fat
  • Using cognitive behavioural therapy, hypnosis, or acupuncture
  • Using vaginal lubricants and vaginal moisturizers.

The researchers say that individualised treatment is very important. If you’re experiencing early menopause speak to your doctor about the best way to manage your symptoms.

25 Sept 2017

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