How to Manage Forced Menopause Due to Breast Cancer Treatment

These first-hand tips for combatting forced menopause side effects can help you live an active and healthy life while reducing your risk of recurrence.

As a young breast cancer patient with hormone-positive cancer, my standard course of treatment included a combination of chemotherapy, surgery such as a hysterectomy, and the dreaded combination of medications (tamoxifen, anastrozole, letrozole, Lupron) that force you into medical menopause.

While doctors warned me about the oncoming forced menopause, I had no idea what to expect and was completely ill-prepared to manage the side effects. For many women, the side effects of hormone-blocking medication can include weight gain, aches, pains, and sexual challenges.

People with cancer who start hormone-blocking medications such as tamoxifen or a combination of letrozole and Lupron may slowly begin to experience side effects. If you’re forced into menopause through surgery, your side effects may come on more suddenly and be more alarming.

Common side effects of forced menopause and hormone-blocking therapies can include:

• joint stiffness
• aches and pains during movement
• weight gain
• trouble maintaining weight
• hot flashes
• lack of energy
• sexual and intimacy issues

Want to know how to manage your forced menopause side effects and find more enjoyment in your life after your diagnosis? Let’s look at some helpful interventions and strategies to combat the frustrating side effects.

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Joint pain

While aspirin may dull joint aches and pains, movement is a really important remedy. It will likely be uncomfortable in the morning when you get moving, but the more you move, the more your joint aches and pains will lessen.

Since your energy levels may also be low, start with low impact movements such as yoga, walking, or biking.

Weight gain and trouble maintaining weight

Gaining weight and struggling to keep weight off during forced menopause is natural but can be extremely frustrating. The decrease in your estrogen due to medications or surgeries has an impact on your body’s metabolism and weight.

If you’re having a difficult time managing your weight due to forced menopause, here are a few strategies to try:

Focus on consistent low impact exercises

During or after cancer treatment, you may not have the energy to do the workouts you once enjoyed. While this can be frustrating, it’s important to be kind to yourself.

With time, you can get back to your pre-cancer energy level. On my cancer recovery journey, I found that daily walks and 10- to 15-minute strength-training circuits three times a week helped manage my weight loss during forced menopause.

It’s important to build an exercise routine you can stick to and be consistent. The short-term benefits for your weight and long-term cancer risk reduction are worth it.

Increase your protein consumption

Dr. Amy Morris, cancer survivor and cancer recovery expert, says, “Without as much estrogen in forced menopause, it is more difficult to keep the lean muscle mass you have or gain new lean muscle. This is why it is very important to start increasing the amount of lean protein in your diet.”

Before cancer, I was very focused on calories. But after cancer, I’m much more mindful of macronutrients and focus on protein consumption. Protein keeps you full longer and aids in your weight loss journey.

If you’re unsure which high protein foods to incorporate or if you’ve found that your tastes have changed after cancer, here are some of my favorites:

• Grilled chicken: I’m a huge fan of Tyson’s precooked chicken because it’s so easy and quick to prep and you can keep it on hand for meals throughout the week.
• Tuna: You can mix tuna in pasta, make tuna salad, serve it on whole grain bread, or enjoy it alone with crackers.
• Greek yogurt: It’s great for breakfast with fruit and nut butter. You can also mix it with seasonings for an easy high protein dip or eat it alone with chocolate for dessert.
• Lean ground turkey: This is an excellent source of protein and can be served so many different ways. Think tacos, meatloaf, burgers, meatballs, salads, and more.
• Eggs: Eggs and egg whites are great sources of protein. Think about how you can mix eggs into your recipes more. Hard boil some for snacks or build your breakfast around eggs. I love making veggie egg scrambles for breakfast with cheese and hot sauce.
• Skim milk: Fairlife is my favorite brand.
• Protein powder: Look for ones with low sugar and no processed soy.
• Tempeh: Tempeh is a high protein wheat and soy product that’s common in the vegan community. I grew up eating it and love making it like tofu. I find if you steam it first it takes flavors and marinades much better.
• Edamame: It’s important to note that previous studies linking soy to breast cancer risk have been questioned. It’s generally considered safe to eat soy products such as tempeh and edamame, but it’s still cautioned for people with a personal or family history of breast cancer.

Increase your vegetable consumption

If you’re not feeling full with the increase of protein, try increasing your vegetable intake as well. Whenever I reach a plateau in my forced menopause weight loss, my nutritionist recommends I reevaluate my vegetable intake.

Adding one to two vegetables to each meal will help you stay full longer and aid in your weight loss journey. I like to roast and steam tons of vegetables on Sunday so I can easily use them for recipes and meals throughout the week.

Intimacy and sexual side effects

The sexual side effects of forced menopause and hormone-blocking medication can be extremely challenging as they’re both mental and physical.

You’re likely grieving the loss of your old body and changes incurred via surgery you didn’t want. You’re also likely combating the sexual impacts of hormone-blocking medication, which can cause vaginal dryness, painful intercourse, and thinning of collagen in the vagina due to a lack of estrogen.

All of these side effects can be uncomfortable to talk about, but it’s important to know that they’re completely normal and there are resources available. While your oncologist may not be trained on treatments for sexual side effects, they can likely refer you to a gynecological pain expert, a pelvic floor therapist, or other sexual health and intimacy resources available in your area.

Treating the physical issues

If you’re experiencing vaginal dryness and painful intercourse, start with these two steps. If your pain and discomfort don’t improve, talk with your doctor about a referral for other interventions such as dilators, topical lidocaine, or low dose estrogen cream in particular cases.

• Daily moisturizer: When your body is put in a state of forced menopause, a lack of estrogen can make the vagina dry and painful. Just like you moisturize your face, it’s important to keep the vagina moisturized as well. This can be done with vitamin E oil from feminine products made for this specific use.
• Lubricant: While your body may have previously supplied natural lubricant, it’s important to use a high quality lubricant while in forced menopause to reduce the risk of pain during intercourse.

Treating the emotional issues

Beyond the physical side effects of cancer, your diagnosis and treatment can have a huge impact on your body image. This can then impact your ability to be intimate with your partner. Add in a lack of sex drive, and the problem can feel insurmountable.

So, how do you address the mental side of these issues? I’ve been struggling in this area for years and found that working on rebuilding my confidence was essential. In addition to my self-love work, I looked to the survivor community and speakers at the annual Young Survival Coalition conference for insight, tips, and tricks.

A few years ago, I was connected with Dr. Lyndsey Harper, who founded Rosy, a powerful app that helps women navigate sex and intimacy through a personalized evidence-based path to sexual wellness. The app has a program specifically for cancer survivors focused on both the mental and physical aspects of recovery and provided actionable interventions I could try based on science.

The bottom line

If you’re having a difficult time with the side effects of forced menopause, know that you’re not alone. While the side effects can be challenging, there are interventions and small lifestyle changes you can make to lessen the impact of this shift in your body. Show your body and mind grace as you navigate recovery. You’re rebuilding yourself one step at a time.