5 Myths about Cancer-Related Early Menopause

Early menopause "doesn't have to be universally terrifying or terrible," says MSK gynecologic surgeon Jennifer Mueller, above.
Summary

Women undergoing procedures for cancer prevention or treatment may begin menopause earlier than other women. Here is a primer on what they can expect.

Ovaries may be small, but they pack a powerful punch. These grape-size organs secrete hormones, produce and house eggs that can one day become babies, and help regulate a woman’s menstrual cycle.

Some cancer treatments and risk-reducing procedures can cause the ovaries to stop working. While this lessens the threat of disease, it can also bring about early menopause. For the average woman, menopause — defined by 12 months without a menstrual period — begins in the early 50s, although symptoms can start in the 40s.

Women facing menopause at a younger age need not fear it, says MSK gynecologic surgeon Jennifer Mueller. Here, she clears the air about what it means to go through these changes earlier than most.

Myth: Menopause is a total drag for everyone.

Truth: Every woman’s experience with menopause is different. While there are some common symptoms that many women report — hot flashes, vaginal dryness, or mood changes, for example — not every woman experiences all (or any) of them. And although there is research supporting the fact that younger women have more intense menopause symptoms than older women, the severity is different for each woman as well. No matter what women face, MSK care teams can prepare them for the road ahead and support them along the way. “Although menopause is intimidating, it doesn’t have to be universally terrifying or terrible, and you can go through it with your healthcare team,” Dr. Mueller says.

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Myth: Menopause is a gradual change, no matter how old you are.

Truth: Older and younger women go through menopause differently. “If you’re going through the average menopause experience, that’s your ovary function saying ‘OK, the gas tank is getting a little low,’ ” says Dr. Mueller. There might be changes over time: a few missed periods or a shift in libido, perhaps. But when a woman is put into early menopause because of a medical procedure or treatment, the effects are more immediate. “Surgery is an abrupt change,” Dr. Mueller says. “Some women wake up from surgery and within a day or two might experience hot flashes.” She adds that as time goes on, women usually develop a good sense of what is caused by menopause and what is just treatment-related recovery. 

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Myth: If you go through early menopause, you can’t have biological children.

Truth: Women have many options for preserving their fertility before risk-reducing surgery or cancer surgery. MSK has fertility experts who can counsel women on all of the available possibilities, including having biological children.

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Myth: Hormone therapy treatment is intense.

Truth: Estrogen and progesterone serve important functions in younger women, protecting the heart and strengthening the bones. When women undergoing early menopause lose their ovaries, it’s important that they still get the benefits that hormones would provide. For these women, the American College of Obstetricians and Gynecologists calls hormone replacement therapy an effective way to manage menopause symptoms and still get health benefits, provided that they do not have a hormone-sensitive cancer or other medical reasons they cannot take hormones. The potential risks and benefits of hormone replacement therapy are different when a woman is going through the average menopause experience.

Some women may be hesitant to start on hormone replacement therapy for fear of side effects, especially those who have had negative experiences with hormonal birth control. Though both boost the body’s hormone supply, the levels of hormone in replacement therapy are lower than those in birth control. As a result, side effects can be fewer. “With hormone replacement therapy, you’re getting smaller doses,” Dr. Mueller says. “You’re getting what your body needs for your bones and your heart, but you’re not getting pregnancy prevention. It’s like a burner on a stove. If you want a simmer, you have a certain setting, and if you want a boil, you have another.”

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Myth: If you’re experiencing menopause symptoms, you just have to ride them out.

Truth: “Your job is not to be home and miserable,” Dr. Mueller says. “Getting back to living and feeling well in your body are really important priorities.” To that end, she says women should tell their care team about any side effects they’re having, physical or emotional. There are hormonal and nonhormonal ways MSK experts can help. It might mean supplementing with a medication or making an appointment with one of MSK’s Female Sexual Medicine and Women’s Health experts. “There are lots of things in our toolbox,” Dr. Mueller says.

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