How do you relieve menopause symptoms if you’ve had breast cancer & can’t take HRT?
One in eight women in the UK develop breast cancer at some stage in their adult life. The diagnosis can be devastating, but just to add insult to injury it can also mean many women are either plunged into an early menopause because of the treatments or encouraged to go off their HRT because of the risk of a recurrence or new breast cancer.
So, on top of having to deal with the cancer itself, there is a host of unwanted and unwelcome symptoms that they also have to deal with.
Professor Isaac Manyonda from the Menopause Clinic London, says these can include:
- hot flushes and night sweats
- anxiety, depression or mood changes
- changes in memory and concentration
- bone or joint aches and pains
- urinary problems such as infections or incontinence
- a low sex drive
- dry skin
- vaginal dryness and painful sex
- bone thinning (osteoporosis) over some years
- sleep problems
- weight changes.
Because Hormone Replacement Therapy (HRT) is no longer an option may suffer in silence, and this can take a huge toll on their personal lives and relationships.
But, according to Professor Manyonda, there are a number of things that can help reduce or relive these symptoms.
Lifestyle changes for hot flushes
To reduce the number or intensity of hot flushes Professor Manyonda suggests:
- keep your room cool – use a fan/cooler if necessary
- spray your face with a cool water
- cut out coffee, tea and nicotine
- wear several layers of light clothing you can easily take off or put back on
- wear natural fibres such as silk or cotton instead of synthetic fabrics
- sip cold or iced drinks
- cut down on alcohol
- have a lukewarm shower or bath instead of a hot one
- put a towel on your bed so you can easily change it if you sweat at night
- if you’re taking tamoxifen, try splitting the dose to half in the morning and half in the evening.
Alternative therapies: hot flushes, mood swings & sleep disturbances
A review of current scientific literature suggests that there is evidence for positive impact of acupuncture on several menopausal symptoms including hot flushes, sleep disturbances, and mood swings.
Similarly, there is some evidence to support the use of yoga therapy to treat hot flushes, sleep quality and stress.
Medications for hot flushes
Many women are prescribed anti-depressants when they are menopausal but this is usually to treat vaso-motor symptoms like hot flushes, rather than depression.
One of these is Venlafaxine. It is an anti-depressant drug that has been useful for some women. It can take 3-4 weeks for it to work but it often reduces hot flushes, relieves anxiety and improves sleep.
Another drug is the blood pressure medication, clonidine. It too may reduce hot flushes, but it takes a few weeks to work.
The anti-epileptic drug called gabapentin can also help reduce the number and severity of hot flushes for some women.
All these medications have some side effects such as drowsiness, dry mouth or constipation but they are generally mild and temporary.
Treatment of vaginal dryness
You can try vaginal moisturising or lubricating products if you have vaginal dryness, Professor Manyonda suggests. These are available from chemists.
Low dose vaginal oestrogen preparations such as vaginal pessaries are safe to use for symptoms such as vaginal dryness, irritation and painful sex even if you have had breast cancer in the past. Very little of the oestrogen is absorbed in the body.
If you worry about taking hormones vaginally (although Professor Manyonda says you should not), there is a novel drug called Ospemifene which can be taken orally to get rid of vaginal dryness. It is not an oestrogen and but has an oestrogen-like effect on the vaginal tissue, but has no effect on the breast.
There are a range of novel non-invasive vaginal rejuvenation treatments available too that use PRP (platelet rich plasma), ultrasound, laser or radiofrequency heat to stimulate the vaginal tissues and improve their function. Evidence is starting to show they can be of benefit for symptoms of stress incontinence and vaginal dryness.
5. Femarelle products
These contain Tofu extract – DT56a (from soy) which may help improve bone health, vaginal health, joint and muscle flexibility, urinary health, energy levels and mood.
Femarelle products are specially designed to provide relief for women experiencing symptoms of the menopause. They are a non-hormonal alternative to HRT to help to improve sleep, increase energy levels and control mood swings.
The Femarelle range includes three products, targeting the most common symptoms at different stages during or after the menopause.
6. Bones and Heart
Other things to consider with menopause are bone and heart health. Lower levels of oestrogen mean the risk of heart disease increases and the bones become thinner and more brittle leading to osteoporosis.
Professor Manyonda says weight bearing exercise is vital for both heart and bones. This means walking, running, cycling or resistance training in the gym. Swimming may help the heart but as it’s not weight bearing it is of little benefit to bones, he says.
He also recommends that you have an adequate intake of Vitamin D. (Public Health England says we should all be taking a Vitamin D supplement). He adds that eating a calcium-rich diet is also vital for you bones, while keeping an eye on your cholesterol level is important for the heart.
And you you are looking for more information can download our free Menopause Guide here. It contains medically reviewed articles on what works and what doesn’t.