The Change

It happens to 50% of breast cancer patients under the age of 35 who require chemotherapy.

For those breast cancer patients who need chemo and are 35-40, the statistics go up to 80%.

If you are over 45, have breast cancer and receive chemotherapy, it’s almost guaranteed to happen to you!

“What are you talking about, City Girl?” you might be wondering.

The Big M. The Change. Menopause.

How does chemotherapy-induced menopause differ from traditional menopause? Dr. Melody Cobleigh of describes it as follows:

“Natural menopause is a fender bender, whereas medical or surgical menopause is like hitting a brick wall at sixty miles an hour.”

That analogy resonated with me. In October 2010, one month after I received my first round of chemotherapy, I began to hemorrhage. By November, I stopped bleeding entirely, and the hot flashes started. Night sweats, sleep problems, and irritability soon became part of my daily routine. And, then, there was the dryness down there. Yes…there!

Think about it. Back then, I was the 37-year-old sex blogger with an active dating life. Once menopause hit, I couldn’t get wet even when I was turned on. If I wasn’t a woman who prioritized sex during treatment, it would have been very easy to just forgo the act entirely. I had to consistently remind myself that this was important to me since my body wasn’t cooperating.

During chemo-induced menopause, traditional sex was painful at times, and I always needed a lot of lubrication. It took me much longer to reach orgasm. Cuddling for more than a few minutes would cause me to get such intense hot flashes that the entire bed would be wet from my perspiration. And, the lack of natural moisture made my pelvic muscles tighten up so much that I felt like I often had a UTI, even though I didn’t.

I didn’t write tons about this all during treatment because I needed to channel my energy in a positive direction. Medical menopause isn’t sexy. It's not easy to talk about. And, it made a tough time in my life even tougher.

Once I finished chemotherapy and stopped estrogen blockers, my menopause side effects subsided. I wasn’t surprised when my period returned in August 2011. However, when my cycle resumed, it was quarterly, not monthly. I wasn’t in full menopause anymore, but I wasn’t back to normal either. I called it, “The Pause.”

Something inside my body finally decided to press the “Play” button, though. I'm pausing no more. My 30-day cycle returned. Menopause is over, although the doctors believe that given my age and chemotherapy, my eggs are no longer viable. I'm hoping that the next time I experience menopause will just be in the words of Dr. Cobleigh, "a fender bender."

What are my tips for female breast cancer patients under the age of 45 who might have to worry about early menopause?

1. Talk to your doctor, nurse or case manager before you start treatment about the possibility of medical menopause. What should you watch out for? What's the protocol if you start hemorrhaging? Will you need to take an estrogen-blocking medication after chemo that could prolong or induce menopause?

2. Think about the long term before you deal with the day-to-day of treatment. Do you want to have biological children? If so, should you meet with a fertility specialist to discuss freezing your eggs before you begin chemotherapy? Err on the side of keeping all of your options open.

3. Be informed! Read as much as you can from reliable medical sources, check out nonprofits such as Fertile Action, and talk to survivors who have been through it before.

4. Make healthy choices for your body. Approximately ¾ of breast cancers feed on estrogen. Many toiletries, including lubricants and vaginal moisturizers, contain parabens, which weakly mimic the action of estrogen in a woman’s body. Select products that are paraben-free.

Did you know that chemotherapy could cause medical menopause? If you are a patient or survivor, what was your experience?

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