Menopause with Hormone Receptive Breast Cancer

[MrsMontyD]

I've recently been diagnosed with hormone receptive breast cancer so HRT has had to stop immediately and my Mirena coil is coming out soon.

I have spoken briefly to the GP at my practice that specialises in menopause and have an appointment booked with her but my options are very limited including for contraception.

I'm wondering if anyone can suggest any herbal or other non hormone based treatments that have helped.

My priority at this point is the dryness/ irritation that's driving me crazy.

Sorry to hear about your diagnosis.

I think you need to speak to a specialist gynae-oncologist regarding menopause as all HRT is off the table really for you. Even vaginal oestrogen to manage vaginal dryness would be contraindicated, so you’d need non hormonal lubricants such as Sylk or Replens.

Contraception wise a copper coil could replace your Mirena, as it’s non hormonal.

Herbal and natural remedies are best avoided until you’ve received specialist advice as some mimic hormones - for example we often suggest a diet high in soy as it’s a natural phytoestrogen but this can exacerbate hormone receptive tumour growth.

I guess you’ll need to stick to lifestyle adaptations for now.

All the best.

It's a tricky one, my GP doesn't recommend a copper coil, I had the Mirena originally for heavy menstrual bleeding as well as contraception and that's a side effect of the copper coil I can't face at the moment. My plan is to have the mirena out and see what happens with periods, at 50 I'm less concerned about contraception but know it's something I do need to be aware of as it's recommended up to 55.

One of the breast care nurses at the cancer centre I worked at offered acupuncture for patients with hot flushes - which for HR+ve cancer is practically everyone.

Lots of patients swore by it.

For dryness we always recommended Sylk or Replens as per @Sidge

Thanks both.

Ah yes with heavy periods you won’t be wanting a copper coil. 😕

Condoms it is then!

I had a consultation with a private specialist. It was helpful to get clear answers.
Basically anything herbal that could help will be unsuitable.
She recommended CBT for hot flushes, magnesium for sleep and a specific anti-depressant if I felt I needed it.

That's helpful thanks. I've had CBT recently for menopausal anxiety which has really helped, amazingly I'm quite calm despite coming off HRT and getting the diagnosis, so far anyway.

My GP has offered anti depressants if I need them but I'm hoping to avoid them. Magnesium I haven't tried I'll look into that, I'm sleeping reasonably well at the moment though with ASMR or Meditations when I can't get off to sleep, pillow sprays and a pulse point roll on.

My main issue currently is tiredness.

CBD oil is helpful for sleep. Alternatively take a look at Marion Stewart (spelling might be wrong, apologies), she had a six week programme about how to manage your menopause naturally.

good luck with your treatment

Sorry about your diagnosis. I've had er and pr + breast cancer. I take tamoxifen. Vaginal oestrogen is not contra-indicated! It is very localised and is not like HRT. My surgeon and oncologist were very happy for me to have it. GP's are not so knowledgeable about this. My GP would only prescribe if I got my oncologist to write to her.

My GP also waited for my consultant to approve topical oestrogen for dryness, that took a while but the consultant did okay it, in the meantime, the GP prescribed Daktacort steroid cream (available over the counter) and a water based moisturiser- worked a treat!

Well vaginal oestrogen isn’t like HRT for most women but there’s a reason GPs won’t prescribe it to women with hormone receptive breast cancer (especially newly diagnosed) without a gynae-oncologists input…

Nothing to do with lack of knowledge, more like professional accountability!

I’m another that’s been prescribed Vagifem pessaries despite having had an oestrogen receptive bc, and being on tamoxifen.
it was prescribed by my bc team/nurse to manage vaginal irritation. It’s working.

Interesting. Those of you who have been prescribed Vagifem, how did you get your bc team to contact your GP? I’m 4 years post-treatment and the only contact I have is annual mammograms.

@MinnieMountain I'm having private treatment so I will see my oncologist once a year while I am on tamoxifen. She wrote to my GP for me.

@MinnieMountain I’m under what’s called an open access clinic where I can call the team and speak to a bc nurse with any concerns. I was also called earlier this year by the bc nurse as they were doing my 5 year review and I brought up the itchiness and vaginal irritation with her during that conversation.
The team then wrote to my gp who set up the repeat prescription.
Could you go back to your GP and ask for them to contact your team/consultant for advice?