The Relationship Between Menopause and Chemotherapy

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The Relationship Between Menopause and Chemotherapy

Cancer has many side effects. Not just the disease itself, but  the treatments as well. Be it radiation or chemotherapy, there can be some factors that can lead to negative repercussions. Did you know that menopause is one such reaction?

What needs to be understood is that menopause induced by chemo is usually not permanent. Here is all the information you need to help you out.

Understanding Menopause

Menopause is inevitable, but having it sooner than you expected can be problematic. Yes, it is a normal part of every woman’s life, just like puberty, but if it arrives before your 50’s, which is the normal age limit for the onset of menopause, it could cause issues.

Menopause is basically a process where a woman’s body undergoes certain changes due to the expiration of the menstrual cycle. The changes can arrive before, at the time of and after the end of menopause. When menopause comes on, ovaries lessen the production of estrogen which in turn ends the production of eggs. This brings in many physical, mental and emotional changes as well.

Almost all women who undergo menopause are susceptible to mood swings. Since the reproductive cycle ends, hormones undergo a lot of changes and this leads to change in temperament. But this too is temporary and ends once the menopause has ended completely. Menopause is only considered permanent once periods do not occur for a 6 consecutive months.

If menopause takes place before the age of 40, it is known as premature menopause or premature ovarian insufficiency. If menopause happens between the ages of 40-50 then it is known as early menopause. They are both out of the ordinary, especially if they happen after the process of chemotherapy.

Women who go through early menopause can face quite a few psychological and physiological changes that need to be monitored by a doctor. If you or someone you know is going through this, then see your medical doctor and ask for help.

Menopause Induced by Chemotherapy

There are many reasons why chemotherapy can lead  to menopause. Here are all the major ones.

  • A normal ovary contains somewhere over 1 million primordial follicles. These reduce by age leading to eventual menopause. When chemo or high dose of radiotherapy is administered, it damages the production or maturation of the follicles. There are times that menses may return, but fertility is damaged.
  • When chemotherapy is given with cyclophosphamide, then the chances of early menopause are the highest. Studies show that women under the age of 30 are 33% likely to see a loss in their ovarian function, 50% of women between the ages of 35-40 will experience this loss and 95% of women over the age of 40 will see severe loss of ovarian functions.
  • Most women who have chemo see that their periods become irregular. Sometimes this can give way to menopause while other times cycles return and fertility is not affected at all.
  • There are times when the menopausal symptoms can be treated effectively and a woman can regain her fertility as well as her normal menstrual cycle.

There are some cases where menopause, or even infertility due to chemo, is irreversible. It usually happens with people who are over the age of 45-50. It happens either because the ovarian cancer led to the removal of ovaries, or because the ovaries got damaged beyond repair.

Dealing with Early Menopause

It is true that early menopause is traumatic, not simply in terms of physical deficiencies but also because of the psychological impact it has. As mentioned before, menopause gives rise to mood changes. Imagine what a woman may go through when she experience loss of her fertility. But this is not the end of hope. Here are some ways early menopause can be managed.

  • The one thing women of childbearing age fear most is the loss of fertility due to early menopause. This is mostly temporary if the woman is young and with some treatments like hormone therapy can be reversed. If on the other hand a treatment for reversal is not an option, there are things like embryo cryopreservation which can be done before the start of chemo to preserve eggs and be able to conceive once cancer treatment is done.
  • There are certain medications like gonadotrophin-releasing hormone agonists (GnRHa) that may be able to help a women from developing early menopause.
  • IVF and adoption are some other way women can have children if infertility results because of chemotherapy.
  • Estrogen therapy is one treatment for women with early menopause induced by chemo. But this is not advisable for all kinds of patients, particularly those who had breast or endometrial cancers. This can cause other problems, hence you will need to ask your doctor’s recommendation before going for estrogen therapy.
  • Early menopause can mean that bones become at risk and osteoporosis can occur. This is why it is essential to become vigilant about bone health once chemo is done. Taking in a calcium rich diet, soaking up Vitamin D and exercising regularly will ensure that bones remain healthy and strong.
  • The most important thing needed if menopause starts early is getting a psych evaluation. Most women have a hard time dealing with changes in their hormones. It is advisable to talk to specialists so that there are no repressed feelings, which can often lead to depression.

Menopause is a natural form of the aging process for women.  There are quite a few variables that can play a role in menopause.  The best option is to have open communication with your medical doctor as you are going through these changes in your body.


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