A cancer related menopause
The above image is what a cancer related medical menopause looks like. I spent Monday afternoon having the above inserted into my body.
The menopause is a natural part of aging for women when at around 50 years of age oestrogen levels decline and their periods stop. Symptoms of the menopause include night sweats, hot flushes, depression, anxiety, loss of libido and difficulty with sleeping, memory and concentration. Some women take HRT (Hormone Replacement Therapy) to relieve these symptoms. A menopause can also be created medically, surgically or as a side effect of the treatment for cancer.
I was pre-menopausal for cancer number one and because my cancer was dependant on oestrogen to grow was prescribed Tamoxifen to block its growth. When cancer number two arrived the treatment needed to be changed and I was put onto another type of drug called letrozole which would work in a different way to Tamoxifen. For the letrozole to work I would need to be menopausal. A blood test revealed that despite being in my late 40s and having had 10 cycles of chemotherapy my ovaries were still going strong and I would need to be placed into a medically induced menopause. Each month I would be having an implant called goserelin put into my stomach.
Within weeks I was fully menopausal. There was no gentle introduction or vague symptoms. My medically induced menopause was deep and brutal. I spent a year not wanting to go on I was so depressed. I would have to force myself out of bed each day to complete the basics of life. My active and lively brain was now slow and foggy. I had no drive or desire to do anything. Because my cancer was oestrogen dependant I was unable to take HRT to relieve these symptoms. I would need to find another way.
I bargained I was still alive after two cancers and that I needed to make the most of my time left and if a brutal menopause allowed that I would just have to get on with it. There was no other choice. I got busy, I got a plan and I got a focus. The more I engaged with life the less depressed I felt. I needed to make an effort on a daily basis to keep the depression at bay. I had both short and long term goals which I would spend time on each day.
The depression was accompanied with high levels of anxiety and I managed this by deleting anything in my life which caused me stress. I couldn’t delete cancer or the menopause but I could revaluate and make changes to other areas of my life. My life is much simpler and streamlined now and I experience considerably less anxiety.
Instead of sleeping for a delicious unbroken eight hours my sleep was intermittent and sweaty. I now only need about six hours sleep and as I don’t get tired during the day have just accepted this and feel grateful to have extra hours in the day to read or relax in.
My joints would be so sore I would be unable to walk by the evening and would have to crawl upstairs to bed, it was a comical scene. I take a joint supplement and keep as active as possible and this has helped alleviate the stiffness. If you are considering taking a joint supplement please consult with your GP or consultant to check this won’t interfere with other medication you are taking.
A post cancer treatment bone density scan known as a DEXA scan revealed I had osteoporosis. The letrozole/goserelin combo would rapidly increase this so I have a bi annual infusion of bisphosphates to prevent further bone density loss. Again forever the bargainer the treatment would reduce the risk of secondary bone cancer so I focused on this rather than the side effects of the bisphosphates.
Weight gain which had not been a previous issue for me, was now a constant issue. Out was the binge eating of family sized bags of crisps and whole packets of biscuits. I liked being a size 10 so I would need to eat less and move more if I wanted to maintain this. I now eat much, much, much less. Every calorie consumed or used counts. The upside of this is I appreciate and enjoy my food more because there is so much less of it.
The shorter term menopausal symptoms lasted for about a year and the longer terms ones I have become accustomed to. I had no choice about the menopause and the lack of medical relief available which in one way was easier to reach acceptance about and focus on other areas of my life which I could influence.
For some patients a cancer related menopause may come in their 20s, 30s or 40s much earlier than a natural menopause and possibly before they have had or feel they have completed a family. This is another loss and lack of choice a cancer patient may face and will have an emotional impact on them. This may also affect intimate relationships and create difference and isolation from friends who are not experiencing a menopause.
How did having cancer affect your menopause?