Cancer and 'crash' menopause

After being diagnosed with breast cancer at 35, Alice MacGillivray went through chemotherapy and a mastectomy then had her ovaries removed.

As a result, she faced the new challenge of a sudden, medical ‘crash’ menopause.

‘Nothing prepared me for it. I was so hot, sweaty and irritable. I’d be going to the shop feeling ok and all of a sudden I would be like an inferno that wanted to explode. The menopause for me was harder than the cancer, it was too much. I wanted to be out of my body.’

What is a crash menopause?

The natural menopause is discussed everywhere in documentaries, podcasts and TV shows with celebrities including Davina McCall, Lorraine Kelly and Oprah Winfrey revealing the impact of its symptoms on their physical and mental health.

What is less talked about are the intense effects of medically or surgically induced menopause, which can be triggered by a range of cancer treatments at any age.

The symptoms, which include everything from hot flushes and insomnia to low libido and brain fog, come on so suddenly and feel so intense that it’s sometimes known as a ‘crash menopause’.

‘A crash menopause can feel like you’re falling off a cliff,’ says Lisa Punt, Centre Head at Maggie’s Cambridge.

‘When we go through a natural menopause there’s a slow, gradual decline in our hormones, but with a treatment-induced menopause, you might go from having normal oestrogen to having a lower level than following a natural menopause, literally overnight. The impact can be far-reaching, affecting your long-term health, intimacy and relationships.’

Menopause – an overlooked side effect of cancer treatment

A survey carried out by Maggie’s shows how few people having cancer treatment are properly prepared for the possibility of going through a medical menopause as well.

The survey found that 30% of people diagnosed with cancer weren’t even aware that their treatment could cause early-onset menopause. On top of that, many said the menopause symptoms they experienced were worse than their cancer treatment.

‘It’s really shocking that so many people aren’t aware their treatment will cause early-onset menopause,’ says Maggie’s Chief Executive Dame Laura Lee. ‘We know how traumatic an experience this can be for people on top of their cancer diagnosis with people experiencing loss of fertility and a range of debilitating side-effects. It is crucial we shine a spotlight on these issues and that information is more clearly available.’

Lisa has spent time with many centre visitors at Maggie’s who’ve had their cancer treatment thoroughly explained to them but weren’t adequately prepared for the possibility of a crash menopause because it was seen as an after-thought or forgotten altogether.

‘In the midst of maybe talking about chemotherapy, mastectomy, and all the other challenges that come with a cancer diagnosis, menopause is something that's not necessarily focused on, but that needs to change,’ says Lisa.

‘One woman I’m supporting at Maggie’s was treated for a colorectal cancer at 22. Her treatment brought on a crash menopause and she said to me, ‘Who would have thought I’d be sitting through my History A-level exam having a hot flush?’ And you know, no one else understood that.’

Liz O’Riordan, has come across medical menopause from two different sides of the hospital environment, both as a former breast cancer surgeon and as a breast cancer patient.

‘As a breast cancer surgeon, I had no idea how hard the menopause was for my patients until I became a patient myself. We aren’t given specific menopause training and often don’t hear about it from our patients as we only have five minutes with them after surgery and then don’t see them again for years,’ she says. ‘That’s why it is so important that people know that they can come to Maggie’s for safe, trusted, expert advice.’

Dealing with the symptoms of a crash menopause

Three weeks after finishing treatment for breast cancer, Anna Cook, 54, went into crash menopause. ‘I found myself really tired but also unable to sleep,’ she says. ‘I had bad joint pain in my hands and my knees.’

But the symptoms weren’t just physical, they affected her mental health and her confidence at work too. ‘I’m a really practical person. I’d worked in the same place for 14 years but one day when I’d gone back to work, I burst into tears in a meeting and this was really embarrassing. That’s when my manager sat me down and I realised that, ‘no, I actually wasn’t okay’ and I wasn’t ‘sailing through this’ at all.’

Hannah Walsh, 40, says the symptoms of menopause hit her ‘like a brick’ after her treatment for breast cancer. ‘Hot flashes and insomnia have been, by far, the worst menopause symptoms for me,’ she says. ‘It would have been different to have had a few years to adjust to it and get there eventually but to crash straight into menopause is difficult in many ways and it’s upsetting because I’m not ready for it.’

How Maggie's can help

Thankfully, support is available. Lisa has developed a two-hour online 'Menopause and cancer' course for Maggie’s that gives support and practical advice on all aspects of the crash menopause.

‘We look at the practical, physical and psychological effects and how to manage them. When people understand how something like a hot flush happens it can be helpful in managing it,’ she explains. ‘We also have some really rich conversations about the emotional and physical impact on intimacy and relationships. It helps make people feel more confident and comfortable when they’re in a group going through similar experiences.’

Maggie’s menopause workshops or individual support are available through all 24 UK centres and have already helped countless people.

Anna found the menopause workshop ‘empowering’. ‘It helped me to meet people who also had cancer and menopause and we could discuss symptoms and problems in a safe and supportive space,’ she says. ‘Menopause is something that every woman is going to go through, so you do feel a bit silly when you have to admit that it really is difficult. I had no idea how much it could affect me mentally and physically.’

After feeling ‘broken’ by the crash menopause, Alice found support and hope at Maggie’s. ‘I’d come into Maggie’s sweating, probably three or four times a week,’ she says. ‘I met others going through the menopause, there was a lot of perspective. I could find the funny side and laugh about it when I spoke to others too.’

Find out more

To find out more about Maggie’s free 'Menopause and cancer' workshops, contact your nearest Maggie's centre, email us at enquiries@maggies.org or call us on 0300 123 1801. Our contact hours are 9–5, Monday to Friday.

You can also find more information about menopause and cancer here.