Living with treatment-induced menopause during or following breast cancer treatment can be difficult to manage. Many treatments push women into early menopause and leave them facing intense symptoms such as hot flashes, night sweats, insomnia, vaginal dryness, sexual dysfunction, bone density loss, joint aches and mood changes. 

Today, there are several clinically tested approaches and practical strategies to make menopause symptoms more manageable for women that have been or are being treated for breast cancer. 

Leading experts, including V.K. Gadi, M.D., Ph.D., Makeba Williams, M.D., Pauline Maki, Ph.D., and Komen Ambassador and founder of Menopausia.com, Gaby Natale, share their insight into some of these approaches in the video below: 

Navigating menopause should be individualized, particularly for those impacted by breast cancer. It usually involves a combination of medications, lifestyle changes, behavioral therapies, sexual health treatments and supportive care. Individuals are encouraged to work with their health care team to create a plan that makes the most sense for their unique needs.  

“I think it’s on us to change the narrative and start changing culture on how we talk about menopause,” says Natale. “The best days are not behind us, that there’s so many wonderful things that still can happen to us. And yes, it may require extra products, extra consultations, a little bit of more extra time, but we need to be so intentional in designing the quality of life that we want for ourselves post treatment and that includes managing menopause.” 

Women are encouraged to discuss these potential remedies with their doctors, regardless of whether a prescription is needed. 

Remedy #1: Oral Menopause Hormone Therapy (MHT) 

Since the underlying cause of menopause is a decrease or loss of the hormones called estrogen and progesterone, one way that doctors typically treat menopausal symptoms is through prescription MHT or hormone replacement therapy (HRT), which can be taken in pill form (oral). 

Oral MHT alleviates severe to moderate hot flashes, night sweats and can prevent bone loss (osteoporosis). However, it may not be an option for everyone. Because estrogen drives the growth of ER-positive breast cancer, adding it back through oral MHT increases the risk of cancer recurrence and/or progression for those impacted by breast cancer.  

Remedey #2: Topical MHTs 

Vaginal MHTs are formulated as topical applications of estrogen to the vaginal area. While oral MHTs (Remedy #1) may not be optimal for some individuals with a history of breast cancer, vaginal MHTs (including suppositories, rings and creams) help alleviate the vaginal dryness and irritation caused by menopause without increasing the risk of breast cancer recurrence for most women. Nonetheless, women are still encouraged to speak to their doctors about the benefits and risks of vaginal estrogen therapies before using these prescribed medications, especially if taking an aromatase inhibitor as a few vaginal estrogen therapies may increase blood estrogen levels.  

Hormone patches are also a form of topical MHTs. However, like oral MHTs, they are not recommended for some breast cancer survivors because of concerns over a possible risk of recurrence. 

Remedy #3: Non-Hormonal Medications 

Several non-hormonal medications exist that can help ease menopause symptoms. A complete list of these drugs, along with possible side effects, can be found here. But the more commonly prescribed medications are listed below. 

• Elizanetant is FDA-approved to treat hot flashes and night sweats. It also improves sleep significantly and reported side effects are minimal.  

• Antidepressants can help with hot flashes and night sweats, in addition to some of the mood changes associated with menopause. 

• Gabapentin is typically used to treat neuropathic pain, but can be used to treat hot flashes, night sweats and joint aches. 

• Vaginal moisturizers and lubricants can help with vaginal symptoms. Moisturizers that contain hyaluronic acid should be used on a regular basis to retain fluid in the vagina. This can help with vaginal dryness, itchiness and discomfort. Lubricants can ease discomfort during sexual intercourse.  

Remedy #4: Wellness Services  

There are several non-pharmaceutical wellness remedies that have shown to be effective in treating menopause symptoms. Consult your doctor to see if these services may be an option for you. 

• Cognitive behavioral therapy (CBT) is a type of mental health counseling that has successfully reduced hot flashes, night sweats and insomnia in some women.  

• Physical therapy benefits often include improved mobility, a challenge that many menopausal women face. 

• Acupuncture may also be an option for reducing hot flashes and night sweats. 

Remedy #5: Healthy Living  

Adopting a healthy lifestyle, which includes physical activity, weight loss for those that are overweight and smoking cessation, can lead to less severe menopause symptoms. A minimum of 150 minutes of exercise per week is recommended. Two types of physical activity have shown the greatest benefits during menopause. 

• Yoga, which involves deep stretching, has been shown to ease the intensity of menopause symptoms. It helps with mobility, improves sleep quality and lowers stress.   

• Strength training and weightlifting provide benefits including reduced bone loss, muscle preservation and improved mobility. 

Don’t Suffer in Silence 

The cost of surviving breast cancer should not include suffering through menopause symptoms. People with breast cancer owe it to themselves to have the best quality of life throughout and following their treatment.  

“Gone are the days that we need to white knuckle it and grin and bear it,” says Dr. Williams. “So, if you are having these symptoms, don’t apologize [and] don’t tolerate them.”  

Breast cancer can bring questions you never expected to have — and moments when you simply need someone to listen. Komen’s Breast Care Helpline connects you with trained, caring staff who are here to listen, answer questions and help you find the information, resources and support you need. Call 1-877 GO KOMEN (1-877-465-6636) Monday–Thursday, 9 a.m.–7 p.m. ET, and Friday, 9 a.m.–6 p.m. ET, or email helpline@komen.org. Se habla Español. 

You can also learn more on Komen.org. For a deeper dive into menopause and breast cancer, check out this blog. 

Statements and opinions expressed are that of the individual and not necessarily the views or opinions of Susan G. Komen. This information is being provided for educational purposes only and is not to be construed as medical advice. Talk with your doctor about what is right for you.