Menopausal Symptoms

Women with breast cancer are at increased risk for developing menopausal symptoms. They may have treatment-induced menopause as a result of chemotherapy, radiation therapy, surgery, and/or tamoxifen therapy (Dow, 2006).

Menopausal symptoms include hot flashes, osteoporosis, and effects on the cardiovascular system and genitourinary tracts.

Estrogen has a protective cardiovascular effect. When estrogen is decreased (secondary to breast cancer treatments), it can result in a higher level of low-density lipoprotein (LDL) cholesterol along with a lower concentration of high-density lipoprotein (HDL) cholesterol (Dow, 2006).

In addition, the vagina and urethra have active estrogen receptor sites in the urogenital epithelium. With menopause, atrophic changes occur in the vagina, resulting in vaginal dryness and dyspareunia. Urogenital atrophy and urinary symptoms can include frequency, dysuria, and stress incontinence (Dow, 2006; Gordils-Perez, Rawlins-Duell, & Kelvin, 2003).

Estrogen and progesterone are both regulators of the endocrine system. Endocrine therapy involves the manipulation of hormone production, receptor binding, and cell signaling. This manipulation can either be permanent, as with surgical oophorectomy, or temporary, as with medications such as tamoxifen (Yackzan, 2007).

Dow, K.H. (2006). A pocket guide to breast cancer (3rd ed.). Sudbury, MA: Jones and Bartlett.

Gordils-Perez, J., Rawlins-Duell, R., & Kelvin, J. (2003). Advances in radiation treatment of patients with breast cancer. Clinical Journal of Oncology Nursing, 7, 629–636.

Yackzan, S.G. (2007). Systemic treatment. In S.M. Mahon (Ed.), Site-specific cancer series: Breast cancer (pp. 91–104). Pittsburgh, PA: Oncology Nursing Society.