The British Menopause Society (BMS) and British Gynaecological Cancer Society (BGCS) recently published a joint guideline providing information for all healthcare professionals caring for women treated for gynaecological cancer.
What does this mean for women undergoing treatment for womb cancer?
In brief, the guideline general recommendations state:
- All women who are likely to go through menopause as a result of surgery, systemic therapy and/or radiotherapy treatment should have a pre-treatment discussion of possible menopausal symptoms and potential management options.
- Women should have access to evidence-based information about menopausal symptoms, HRT and alternative treatment options.
- Evaluation of symptoms and individual needs should be reassessed on a regular basis, with annual review once stable.
We hope that all women facing gynaecological cancer treatment will be offered the support and options they need to navigate the impact of early onset menopause caused by their cancer treatment.
Dr Helen Clarke, Chair of Peaches Womb Cancer Trust, answers some of the questions you may have about the menopause during or after treatment for womb cancer below.
What menopause symptoms might I expect?
Common symptoms are:
Vasomotor – hot flushes, night sweats
Musculoskeletal – joint and muscle pain
Sexual difficulties – low sexual desire
Psychological – low mood, anxiety
Urogenital – vaginal dryness, bladder symptoms.
How quickly might I experience symptoms after surgery/treatment?
If you are pre-menopausal at the time of surgery, removing the ovaries causes a surgical menopause and symptoms can appear very quickly, sometimes immediately after the operation.
What menopause treatment options are out there for me to discuss with my medical team?
In many cases, menopausal symptoms will get better on their own, although it’s difficult to predict how long you may have them for and how much they will affect your quality of life. Each person is different.
Hormone replacement therapy (HRT) is the recommended treatment for hot flushes and can be highly effective. However, it may not be suitable for women with some types of cancer.
Alternatives to HRT include medications called SSRIs or SNRIs (selective serotonin- or norepinephrine-reuptake inhibitors). These medications are generally used to treat depression, but they are also effective at reducing hot flushes and may be helpful if HRT is not an option for you.
Other drugs – including oxybutinin, gabapentin and clonidine – may also help to reduce hot flushes.
Here are some questions you might want to raise with your medical team prior, or during, treatment for womb cancer:
- What can I take to manage the menopausal symptoms with my type of womb cancer?
- Do I have to take HRT?
- Can I consider alternative treatments to HRT?
- You cannot assume that your healthcare team will ask you about your sexual health – you may well need to raise the topic yourself. It can sometimes be difficult to start a conversation about sex with someone from your healthcare team. Some women feel embarrassed or uncomfortable, but it is important to ask questions.
- It is important that you tell your healthcare team of any changes in the way your body feels. Keeping a diary can be helpful when tracking the symptoms you’re experiencing to discuss with your nurse or doctor.
- For younger women, there may be options for preserving your fertility. However, it is not always possible to preserve fertility in a woman with gynaecological cancer. Your risk of infertility depends both on the dose of radiotherapy you have and your age. Fertility is less affected by chemotherapy.
You may also find the following Peaches Support Video helpful:
Menopause after womb cancer
