Managing Menopause Symptoms
Many women strugg;e with menopausal symptoms after breast cancer treatment. Women who had been taking HRT must suddenly stop. Women who receive chemotherapy often lose their periods, sometimes after only one cycle of treatment. Younger women who are taking Tamoxifen sometimes lose their periods, even if they did not while on chemotherapy.
The two most troublesome areas generally are hot flashes and sexual changes, most particularly vaginal dryness and diminished (or absent) libido. It is hopeful that physicians are beginning to pay more attention to these quality of life issues. It is also very important that we speak to our doctors about our concerns. I can promise you that attention is being paid and progress is being made because women are speaking up. Keep talking.
Practical clinical guidelines for assessing and managing menopausal symptoms after breast cancer
1*, C. Saunders2, A. Partridge3, N. Santoro4, H. Joffe5 & V. Stearns6
School of Women's and Infants Health, King Edward Memorial Hospital, University of Western Australia; 2School of Surgery and Pathology, University of Western Australia, Australia; 3Department of Obstetrics, Gynecology, and Women's Health, Dana-Farber Cancer Institute, Boston, MA; 4Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA; 5Department of Psychiatry and Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA; 6Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine,Baltimore, MD, USA
Received 19 February 2008; revised 18 April 2008; accepted 21 April 2008
The purpose of this study was to provide practical, evidence-based guidelines for evaluating and treating common menopausal symptoms following breast cancer.
Literature review of the causes, assessment and management of menopausal symptoms in breast cancer patients.
A number of nonhormonal treatments are effective in treating hot flashes. Whether pharmacological treatment is given will depend on the severity of symptoms and on patient wishes. For severe and frequent hot flashes, the best data support the use of venlafaxine, paroxetine and gabapentin in women with breast cancer. Side-effects are relatively common with all these agents. For vaginal dryness, topical estrogen treatment is the most effective but the safety of estrogens following breast cancer is not established. There are limited data on effective treatments for sexual dysfunction during menopause.
Menopausal symptoms after breast cancer should be evaluated and managed as warranted using a systematic approach and may benefit from multidisciplinary input.