The menopause at 32… Fun.
As if surgery, chemotherapy, and radiotherapy isn’t enough for your body to have to go through, those of us with hormone positive breast cancer will also need additional hormone therapy for 5 to 10 years putting you in (early) menopause…. Yep, I’m gonna get to go through the menopause twice!
Like I said… fun.
In a nutshell, hormone therapy works by taking medication to reduce the amount of oestrogen in your body and block oestrogen receptive cancers by starving them of their source. On the plus side, it can reduce a recurrence by up to a third, but the downside is being put into chemically induced menopause and dealing with all the shitty side effects that go with it.
In my case, the little bugger in my boob itself wasn’t hormone receptive, but the sneaky cells that had found their way into my lymph nodes were, so because of this, my oncologist recommended monthly Zoladex injections (which essentially shut your ovaries off and stop them producing oestrogen) followed by tamoxifen once chemotherapy had finished.
I started my Zoladex treatment before my chemotherapy to try and help preserve my fertility. In it’s path of destruction, chemotherapy affects the function of your ovaries and can leave you unable to have children… because I had declined fertility preservation due to not wanting to delay chemo, “turning mine off” before, would possibly reduce the risk of infertility (my odds are still pretty feeble though, don’t count on seeing any more mini me’s running around)
For those that don’t know, Zoladex is a monthly injection into your stomach. The syringe leaves a small, slow release tablet under your skin which gradually releases a chemical (goserelin) into your body and keeps your ovaries switched off. I’m not going to sugar coat it either, the needle is fucking massive. Huge. Like a babies arm. Honestly, don’t google it if you’re not great with needles, I accidentally did and was horrified at what I saw. Saying that though, the nurse is so used to administering them that it’s over super quickly and it doesn’t feel too bad (plus, I’ve got some extra padding thanks to the insane amount of steroids I was on)
Tamoxifen is a daily tablet that blocks oestrogen. From what I understand, in very simple terms… the Tamoxifen is to hoover up any rogue oestrogen that manages to escape the Zoladex.
Anyways, on to the good part… the side effects. Obviously these will differ for everyone, and research shows medically induced menopause is more likely to cause menopausal symptoms than natural. There are also additional side effects from prolonged ovary suppression to contend with. Oh, and don’t be thinking you can simply pop some of the wonderful HRT most menopausal women get access to, because you can’t take it. Same applies for a lot of the alternative therapies that are supposed to help, as they can interfere with your hormone therapy. YAY.
Hot flushes -
I will literally go from freezing to sweating in 2 seconds flat. It starts at the top of my head and spreads like prickly heat wild fire down my whole body. I go red, sweaty, and feel like I’m suffocating. Some days I get one every half an hour and they last 5 minutes each. That’s a lot of sweat. I’ve taken to carrying a hand held fan around with me everywhere, and at night I sleep with a Dyson fan permanently blowing on me.
Night sweats -
See previous point… these are basically just hot flushes at night. But for some reason, they are more brutal and last longer, making it impossible for your husband to want to share a bed with you. Sometimes I’m even hot and cold at the same time, I know, how is that even possible right?
Insomnia -
I’ve had trouble sleeping in the past, but I’ve always managed it. Now though, I’m lucky to get 4/5 hours, which means I’m tired on top of already being tired.
Fatigue -
To be honest, it’s hard to say whether my permanent state of exhaustion is a hangover from the chemo fatigue, caused by the night sweats and insomnia, or whether it’s a whole additional side effect on its own. I’m slowly getting used to having to go at a much slower pace than before whilst my body recovers and adapts.
Weight gain (particularly around your waist) -
Nearly 80% of people diagnosed with breast cancer gain weight, which is a real problem for me as I’ve always suffered terribly with low body confidence. I put some weight on through my last couple of rounds of chemo due to the insane amount of steroids I was devouring, the change in my appetite and taste, and the inability to do any exercise. I felt dreadful, still do. I’m slowly shifting these pounds and I am DETERMINED to be fitter, stronger, and healthier than ever before which will also hopefully counteract any pesky poundage trying to creep on.
Decrease in sex drive -
The libido has LEFT THE BUILDING. I mean, that could also have something to do with the fact I definitely do not feel my most sexy. Bald, a little bit fat, and boobless… What a treat I am.
Joint pain and stiffness -
I experienced quite bad nerve damage when I was having Docetaxel and my fingers are still not quite recovered. And now, on top of that, I’ve noticed that my hands are incredibly stiff and sore. It’s difficult for me to move them when I wake up in the morning and I struggle with things like undoing fiddly buttons, bottles etc and I’ve become even more clumsy than I used to be and rather prone to dropping things.
Then there are the things I’ve not experienced (yet) but I’ve been warned about -
Nausea
Anxiety
Mood changes (I think I’ve done ok so far considering, I’ve not had any mood swings but definitely down days… but who doesn’t have those, especially when dealing with cancer and covid!?)
Oh, and finally, osteoporosis. Yep, old lady brittle bones… Lack of oestrogen over a long period of time can cause bone thinning. To combat this I’m going to be given bishosphonate treatment to try and maintain bone strength (and help prevent any potential recurrence in my bones) which will be starting in the not so distant future (off to iron out the details with my oncologist later this week!)
I found this quote when I was researching ways I could try and help some of my side effects and it really resounded with me, like I mentioned earlier, I thought my breast cancer treatment was just going to be surgery, chemo, and radio and then back to normal. I never realised that actually it goes a whole lot further than that and there is probably no “normal” when it comes to my body anymore.
“Menopause on top of a breast cancer diagnosis can be more than a major disruption. It can wreck your sex life, dash hopes of having a baby, trigger mood swings, produce debilitating hot flashes, cause weight gain, drain your energy, worsen aches and pains, bring on jealousy or anger or resentment, and leave you feeling bad about yourself. You may find it’s these menopausal changes, not the breast cancer or immediate effects of treatment, that interfere most with your quality of life.”-- Marisa Weiss, M.D., chief medical officer, Breastcancer.org
I’m not going to lie, there are definitely times when I wonder if it’s actually worth it. I know it probably sounds stupid to someone not going through it; when it’s giving you security of a reduced risk, but to know you are going to have to go through the next 5-10 years of your life with such a wide array of sometime debilitating side effects… it’s a lot to take in.
I would love to hear from you, how do you deal with hormone therapy side effects or menopausal side effects?
Until next time, check your boobs
L x