Cancer treatment induced menopause - any tips?

[Bubblebu]

Hi
I am going through breast cancer treatment which includes a medically induced menopause. (for any medics, to be precise, monthly zolodex injections and daily Letrozol tablets),
Both have been successful at terminating my periods. However the hot flashes and mood swings have been horrendous and the Letrozol strangely gives me hot flashes and very itchy skin (but almost like it is under the skin not on top of the skin as there is no redness/flakiness of the skin etc) especially at night which is really maddening and disrupts my sleep.
Can anyone recommend anything (for example herbal remedies / health shop supplements or other tips / products) which might help.

There are times when I really hate myself and wish I could just get a grip!
Any recommendations very much welcomed - thanks in advance.

I'm really sorry to hear about your issues. Must be so hard.

I don't have any real advice other than trying to steer you in the right direction a little.

Some women find meds for high blood pressure or some anti depressants can help with hot flushes.

I'd not go down the route of herbs etc because most act like estrogen. Some are not considered safe for women who have had BC.

To be honest, you need the help of a menopause specialist who is familiar with treating women like yourself.

As the NHS stands at the moment it's going to be hard to get that support. Ideally it ought to be a team effort between your oncologist and a menopause gynaecologist.

There are some very good meno consultants working remotely if this was an option but it would be private treatment and fees are charged.

Is this an option for you?

ps You might find more information on the website of Dr Louise Newson who has loads of stuff there and also there are podcasts on Liz Earle Wellbeing from menopause experts.

If you want to stay within the NHS your best bet is the meno clinic at the Chelsea and Westminster hospital London where they work with women like you but understand the location might not work.

thank you Jingling that is so helpfull i will look into it - yes my cancer unit (a v good one but even so) went totally silent on me for 5 weeks between my op and the first contact about radiotherapy - so as you say i might have to be more pro active.

the itchiness at night time (not skin, something underneath) which i think is a side effect of letrozole is starting to drive me bonkers!

do you agree that i should 100% cut out caffine and alcohol?
thanks for replying to me

Alcohol and coffee can make flushes worse but I guess you need to see how you manage maybe with a small amount?

There is a controversial opinion on estrogen and BC- an American dr believes it isn't an issue. I don't know if you would find many UK drs who think this, but some will allow HRT after BC if quality of life is so poor.

lizearlewellbeing.com/making-sense-of-hrt-nick-panay/

worth a listen

I had a reaction to letrazole too. My oncologist put me on Tamoxifen. Both made my arthritis really bad to the point where I could hardly walk.
In the end I took the chance of coming off them completely. That was three years ago, and luckily I've had no recurrence.

Hi Bubblebu. High strength cod liver oil/fish oils, and, high strength evening primrose/starflower oil may all help the itching skin. As will eating avocado, nuts and oily fish. If no appointments available, you could ask GP over the phone if the natural supplements are safe to take with your meds? So sorry you are going through all this xxx

Hi Op I went into menopause after my mastectomy 4 years ago when I started om Tamoxifen. My periods stopped overnight. My cancer was strongly estrogen positive. It was incredibly hard to deal with whilst also coming to terms with what I'd been through, I expect that's the same for you? Doesn't seem bloody fair does it?! I'm afraid in 4 years I haven't received any help for this, my Gp offered to half my Tamoxifen dose (Jeez as if I would do that!) or have counselling / antidepressants!! Wow I didnt realise we could just be counselled out of hot flushes!
So it's been a case of a cold gel insert in my pillowcase (from Amazon) and a jug of iced water by my bed. The body shop do a peppermint foot spray which is very cooling and soothing, there is also a spray called magicool (Boots or Amazon) which is lovely.

Please don't hate yourself. I gave myself such a hard time over this when actually we should be very kind to ourselves, we've been through a tough time.

Thanks for all your replies - i will certainly try fish oil/evening primrose etc.
Did anyone find that letrozole gave them nausea vomiting and/or digestive problems?
I really hope my hot flashes get better as some days I cannot imagine going back to work after my sick leave and coping with the office. My boss is not a sympathetic type at the best of times. Will be absolute hell and i am worried about money/coronavirus as it is. What a nightmare.

@Bubblebu You do have a right to an expert opinion on this. If you are in the UK, your GP can refer you to the Chelsea and Westminster meno clinic and the appt times used to be 6 weeks.

I think what you will find is that there are a range of opinions on what to use. Some very eminent breast cancer specialists are happy for women to carry on / use HRT if their symptoms are really bad.

You really need a team effort between the menopause gynaes and oncologists.

Maybe push your GP for a referral. Even though the C&W is in LOndon, they will do follow up appts by phone- all this is on their website.

Jingling that is so helpful
Unfortunately I am in Oxford so not sure I would get a referral to C&W (even in normal times!) but I guess I could ask. Thank you for your very helpful and knowledgeable reply (I currently lie in bed pushing the covers off and then pulling them back on again every 15 minutes like most nights! urrgghhh!! (thankfully I have the bed to myself so not driving anyone else crazy huh!)

@Bubblue Anyone can get a referral to the C&W! It's on their 'admission's page under menopause clinic on their website.

They see women from all over the UK as this is THE clinic for women with complex meno issues.

www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/referrals

brilliant thank you so much Jingling I am so grateful to you - I will ask my oncologist about it (another night of on off broken sleep with hot flushes through my body and fighting off grumpiness with my kids whilst they eat their Weetabix poor mites) - thank you I really appreciate your help

Good luck!

Hi , I’m in a very similar situation, I have only been on those medication for two month and already feel frighten , I lost ability to have an orgasm easily ( I know some will say it’s a luxury, but that’s how I was build ) i stopped being wet down below and starting having problems in the bedroom.
Hot flashes are horrendous , it literally come from nowhere and make you looks as if you just come out of the shower ( embarrassing, for me anyways ) .
I m 49 and really not ready for menopause, it make me scream just to think of the fact that I will lose that natural experience like most women do . I don’t have so much mad moods , hence I do feel very low and depressed and as if my life have stoped . I guess it also could be because I’m going through divorce ( vines 2019 just after I have been diagnosed with B cancer ) wish it could finish sooner.
Any tips how to deal and what to expect will be much appreciated. Is there anything that can help to sleep better ?

Just to note, there are some antidepressants that can be taken to lessen/manage hot flashes, which is why those were offered, has nothing to do necessarily with depression. You may want to speak to your MO (do you have one? sounds like potentially not if you didn't need chemo), if you don't have one then try and get a specialist referral from the GP. This is pretty common practice and should be doable to try in a low-dose form.

Id also suggest watching alcohol and refined sugars as at least for me they can bring on some hot feelings.

I was on Zoladex and letrozole but had my ovaries removed earlier this year as the monthly zoladex shots were too tedious to deal with. However, I am lucky in that I have few if any hot flashes, no night sweats, and frankly getting rid of my hormones was great for me - much more mellow, less anxious, etc. My mother didn't have a problem either and for that I am thankful because I got a really, really shit hand on the cancer side of things.

Hi , thanks for the reply, I am already on antidepressants call Ventablue XL 37.5 mg , which I found works best for me than others I tried over years .
My hands also developed RA , real pain in the neck and now I have to start new treatment very soon for that as well .

Oh yes and one more thing I found helpful is to take Letrozol at night time .
Girls , can anyone share and experience with their sex life ? Libido , can you reach an orgasm etc ? I found it is very frustrating, I have so much changes in the past month , very suddenly ... it make me scared

If you have had a mastectomy (I had a right breast mastectomy) has that negatively impacted your sex life?

Did you decide to have a reconstruction and if yes, how did it go? did you think it was successful and did it make you feel better about yourself?