HRT involves taking drugs that contain hormones such as oestrogen, progesterone and testosterone. The use of HRT is sadly a complicated and neglected topic for women who have had breast cancer. Breast cancer cells, with hormone receptors may be fed by oestrogen and even those without hormone receptors can go on to develop oestrogen positive tumours.
Treatments without hormones: There are non-hormonal approaches for controlling menopausal symptoms and these are generally first line. Drugs such as gabapentin, clonidine, selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) may be offered for hot flushes and/or mood changes.
The new none-hormonal treatment for hot flushes; Fezolinetant is likely to be a game changer for women experiencing flushes, if it’s cost is not prohibitive. Women currently taking Tamoxifen or an aromatase inhibitor and suffering from vasomotor symptoms may wish to enrol on to the Oasis four trial.
Modifications to your way of life: Some lifestyle adjustments can also help you manage menopausal symptoms. Regular exercise, a healthy diet, relaxation techniques, and staying away from stressors like caffeine and spicy foods may help. Hot flushes may be reduced by layering your clothing and employing cooling methods like fans or cold packs or cooling pillows like the Chillow pillow, or a cheaper pet version!
Vaginal symptoms: Menopause can lead to vaginal dryness, discomfort during sexual activity, and a higher risk of urine infections. To treat these symptoms, non-hormonal moisturisers are available, or vaginal oestrogen can usually be offered.
Support and counselling: Menopause and its effects after breast cancer can be emotionally challenging. Seek out therapists, support groups, or medical specialists who are trained in managing menopause or cancer survivorship. They can advise you, help you develop coping mechanisms, and deal with any worries you might have.
Hormone replacement therapy can be considered on an individual basis following careful counselling and usually after other options have been exhausted. Unfortunately it is unlikely to be risk free.