Early menopause
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Content written in partnership with Macmillan Cancer Support
What is early menopause?
Usually, before menopause, your ovaries make hormones (oestrogen and progesterone) that help control your periods each month. When natural menopause happens, the ovaries slowly stop making these hormones, and your periods eventually stop. This normally happens naturally between ages 45 and 55, but sometimes cancer treatments can make it happen earlier.
Some cancer treatments can change how your ovaries work, which might cause menopause to happen earlier than usual – before the age of 45. This is early menopause.
Early menopause can happen when some treatments for cancer – like chemotherapy, radiotherapy, surgery – or other medical conditions affect the way the ovaries work.
This can stop them from producing hormones like oestrogen and progesterone. These hormones are important for regulating your menstrual cycle and supporting other functions in your body.
When the ovaries stop working, periods may stop suddenly. This is different from natural menopause, which usually happens slowly as you get older.
Early menopause due to cancer treatment can cause some symptoms that are similar to natural menopause, but these might start more quickly or feel stronger because the hormone levels drop suddenly.
Even though it might feel overwhelming, it’s important to know that your doctors and healthcare team are here to help you manage these symptoms and adjust to the changes, so you can keep feeling your best while focusing on getting better.
Coping with early menopause & cancer
Dealing with symptoms of menopause can be hard when you’re already coping with cancer as you might be living with side effects of cancer treatment. This can make it difficult to know what is causing any symptoms and what might help to manage them.
The symptoms of early menopause may be different depending on your individual situation, for example the treatment you’ve had and your age. Symptoms may be worse or start more suddenly if you have early menopause that has been caused by cancer treatments.
Signs & symptoms of early menopause
The change in hormone levels can cause symptoms of menopause. These include:
• Loss of interest in sex
• Hot flushes and sweats
• Difficulties when sleeping
• Dry skin
• Aches and pains
• Needing to wee more than usual
• Brain fog
• Less confidence
You might have all the symptoms or just some of them. The symptoms can also vary from mild to severe.
Your symptoms might be temporary if they’ve been caused by some cancer treatments like chemotherapy, but in some cases, they can be permanent.
Your doctor might be able to let you know if your menopause is likely to be permanent, but this is difficult to know.
What type of cancer treatment can cause early menopause?
Chemotherapy
Some types of chemotherapy can affect your ovaries and reduce their ability to produce hormones like oestrogen. This can lead to early menopause, especially if you need strong doses or long-term treatment.
Radiotherapy
If you receive radiotherapy near your pelvic area, it can affect your ovaries. Radiotherapy can damage the eggs in your ovaries or affect how well your ovaries work, potentially leading to early menopause.
If you want to learn more about pelvic radiotherapy and how it can affect you, take a look at Macmillan’s page on pelvic radiotherapy. It covers treatment, side effects and what to expect during follow-up care.
Surgery
Surgery that involves removing your ovaries will cause immediate menopause because your body will no longer produce the hormones needed for your menstrual cycle. This surgery might be necessary to treat certain cancers or other medical conditions.
Hormone therapy
Some treatments for breast cancer or other hormone-related cancers involve taking medications that lower or block oestrogen in your body. These treatments can trigger menopause-like symptoms or lead to early menopause.
Early menopause can be a big adjustment, but you don’t have to go through it alone. With the right support and information, you can manage the changes and continue to focus on your health and well-being. Don’t hesitate to ask questions or seek help from your healthcare team-they’re there to help you navigate these changes every step of the way. For more information and support, you can visit Macmillan’s Menopause Awareness page, which provides guidance and resources to help you through this journey.
How can cancer & early menopause affect my sex life
Cancer and early menopause can bring some changes that might affect your sex life. The treatments you’ve had, or the drop in hormone levels from early menopause, might make you feel different.
You might notice changes in your energy, mood or even how your body responds during sex. Sometimes, things like vaginal dryness or discomfort can happen too.
You’re not alone in this. Your healthcare team are here to help you manage these changes. There are ways to make things more comfortable and help you feel more like yourself again.
It can feel embarrassing to talk about sex or changes in your vagina, but remember that your GP or cancer team are used to talking about it.
It’s important to talk about any worries or questions you have because there are lots of options and support to help you. Plus, you don’t have to be in a relationship to ask about sex.
For more information on how cancer can impact sex and intimacy, and to explore the resources and support available, take a look at Macmillan’s Sex and Cancer page.
Cancer treatments and early menopause can lead to physical changes that might affect your sex life. One common change is vaginal dryness, which happens because your body isn’t producing as much oestrogen as before. This can sometimes make sex feel uncomfortable or even painful.
You might also notice that your body’s response to sexual activity has changed. You might experience a loss of interest in sex.
Many changes caused by cancer treatment are temporary and usually get better after treatment. As you recover, you might find that your sex life goes back to the way it was. On the other hand, it’s also important to know that some changes may last longer or be permanent.
It’s not just physical changes that can affect your sex life; emotional and mental changes play a big role too. Early menopause, along with the stress of dealing with cancer, can sometimes lead to anxious feelings, feeling low or lowered self-esteem.
These feelings can make you less interested in sex or make it harder to enjoy it. You might also feel tired more often, which can lower your energy for intimacy.
If you’re struggling with the emotional impact of cancer and early menopause, Macmillan Cancer Support can help. The Macmillan Support Line offers confidential support to people living with cancer and their loved ones.
Macmillan’s online community is also a safe space to chat anonymously to other people who understand what you’re going through.
Cancer treatment can sometimes change the way you see yourself. Whether it’s due to weight changes, hair loss, scars, or other physical changes, you might feel less confident about your body.
These feelings are completely normal but can impact how you feel about being intimate with someone. Remember that your worth isn’t defined by these changes, and with time and support, many people find ways to regain confidence.
Macmillan have put together a guide to help support you through cancer treatment and the changes to your body.
It’s important to talk openly with your partner about what you’re experiencing. Letting them know how you feel, both physically and emotionally, can help them understand what you’re going through.
Together, you can explore new ways to be intimate that feel comfortable and enjoyable for both of you. Sometimes, this might mean trying different activities, using lubricants to help with dryness or spending more time connecting in non-sexual ways.
There’s no need to go through this alone. Your healthcare team can offer advice and treatments to help with physical symptoms like dryness or discomfort. And if you feel that talking to someone might help with the emotional and mental side of things, they can also refer you to a counsellor or therapist who specialises in sexual health.
Remember, changes in your sex life don’t mean the end of intimacy. It’s okay to take your time and explore new ways of reconnecting with your body. Intimacy is about more than just sex-it’s about closeness, trust, and being there for each other. You and your partner can still share special moments that bring you closer, even if they look a little different from before.
How can cancer & early menopause affect my fertility?
Fertility is your body’s ability to have children. Cancer treatments and early menopause can affect this in different ways. Normally, your ovaries release an egg each month, which is part of how you can get pregnant.
But treatments like chemotherapy, radiotherapy or surgery, and the changes from early menopause, can affect the ability of your ovaries to release eggs or produce the hormones needed for pregnancy. For more information on cancer treatments and fertility please visit Macmillan's fertility and cancer page.
How do cancer treatments affect fertility?
Some cancer treatments can directly impact your fertility. For example, chemotherapy and radiotherapy might damage the ovaries, affecting their ability to release eggs. Surgery that involves removing the ovaries or parts of the reproductive system can also affect your ability to get pregnant.
Some of these changes can be temporary for some people, but for others, they might be permanent, meaning they won’t be able to have children naturally.
Some cancer drug treatments can make it harder for you to get pregnant, but not all of them do.
Cancer drug treatments include:
- Chemotherapy
- Targeted therapy
- Immunotherapy
- Hormonal therapy
Sometimes, chemotherapy can make your periods stop, but you could still be producing eggs, which means you might still get pregnant. However, because cancer drug treatments can harm a baby, it's important to use reliable contraception. Your doctor should talk to you about this.
Radiotherapy is a treatment that uses powerful rays to help destroy cancer cells. Doctors aim the treatment very carefully to target the cancer as precisely as possible. This means that radiotherapy usually only affects fertility if the treatment area includes parts of the reproductive system or the pituitary gland, which helps control certain hormones.
Here are some examples of how fertility might be affected:
- Pelvic radiotherapy – this type of treatment targets the area between your hips and below your belly button. It may affect parts that control your reproductive system, but it may be possible to protect the ovaries. Talk to your doctor or cancer care team for more information.
- Radiotherapy to the brain – if the treatment involves the pituitary gland, it can impact the hormones that control your reproductive system
- Total body irradiation (TBI) – this is when radiotherapy is given to the entire body, usually before a donor stem cell or bone marrow transplant. TBI often causes permanent infertility
However, there are ways to protect the ovaries during pelvic radiotherapy. Your doctor can explain if any of these options are suitable for you:
- A lead shield might be used to protect the ovaries during treatment
- In some cases, keyhole surgery can be done before radiotherapy starts to move the ovaries away from the area being treated, this is called ovarian transposition
It's important to remember that doctors will take every step possible to protect your fertility during treatment, and they will explain all the options to you to help you feel more comfortable and informed. For more information on fertility and radiotherapy visit Macmillian's Side Effects of Radiotherapy page.
Whether infertility lasts a short time or is permanent depends on the treatment you receive. You can ask your doctors if the treatment you're having might cause infertility, but sometimes they might not know for sure, which can be hard to deal with.
With temporary infertility, your periods might become irregular or stop during treatment, but they should return to normal once treatment is over. This is more likely to happen if you’re younger. It might take a few years for your periods to get back to normal, but you could still get pregnant. Make sure to speak to your healthcare team about contraception and how long you should use it. Permanent infertility is more likely if you have higher doses of chemotherapy or radiotherapy or if you’re older and nearing the age when menopause would naturally happen. Some chemotherapy drugs can damage the eggs in your ovaries. If this happens, you won’t be able to get pregnant, and you might have menopause symptoms.
If having children is something you’re thinking about, it’s important to talk to your doctor before starting cancer treatment. There might be ways to preserve your fertility, like freezing eggs or embryos.
These options are not always available for everyone, but your healthcare team can help you understand what might work for you and make a plan that fits your needs.
Finding out that cancer or menopause could affect your fertility can be difficult. It’s normal to feel sad, angry or confused. Talking to a counsellor, joining a support group or discussing your feelings with someone you trust can help you process these emotions.
Remember, there are different paths to building a family, including adoption, fostering, or using donor eggs, if that’s something you want to explore in the future.
If you’d like to know more about how cancer and its treatment can affect fertility, Macmillan have put together a guide to help answer any questions you might have.
Managing symptoms of early menopause due to cancer treatment
Before the age of 45, you might not be thinking about menopausal symptoms like vaginal dryness, but early menopause after cancer can bring about a variety of symptoms. It’s important to know that there are ways to manage them so you can feel more comfortable, whatever age you are.
Some common symptoms include hot flushes, night sweats, mood swings, trouble sleeping, and vaginal dryness. These symptoms can feel intense because of the sudden drop in hormone levels, but there are several ways to find relief.
For more information and support, you can visit Macmillan’s Menopause Awareness where they provide guidance and resources to help you through this journey.
Hormonal treatments
For some people, hormone replacement therapy (HRT) can be an effective way to help manage menopause symptoms.
HRT involves taking hormones like oestrogen to help replace the hormones that your body isn’t producing and help to reduce symptoms.
It’s important to know that HRT isn’t suitable for everyone, especially those who have had hormone-related cancers like breast cancer. This is because HRT contains oestrogen which can increase the risk of cancer coming back.
If your cancer isn’t hormone-related, you might be prescribed HRT to help improve your menopausal symptoms and also help to protect your heart and bones. It’s important to talk to your doctor before taking it.
Non-hormonal ways to manage symptoms
Complementary therapies
If you’re experiencing menopausal symptoms, some complementary therapies might help you manage them. It’s important to talk to your cancer doctor or nurse before trying any of these therapies, as some could affect your cancer treatment.
If you’re interested in trying a complementary therapy, make sure to find a therapist who is properly qualified and registered. Your GP can help to provide more details, and some therapies might even be available via the NHS.
Support & communication
Don’t hesitate to talk to your healthcare team about what you’re experiencing.
They can help you find the best ways to manage your symptoms, whether through medications, lifestyle changes or other treatments.
It’s also important to communicate with your partner or loved ones about how you’re feeling, so they can support you during this time.
Breathing techniques
Using a slow, controlled breathing method, known as paced respiration, might help manage hot flushes. Here’s how to do it:
- Find a quiet place where you can sit comfortably without being disturbed
- Keep your rib cage still and breathe in and out by moving your tummy muscles
- Without moving your rib cage, breathe in for five seconds and then breathe out for five seconds
It’s recommended to practice this for 15 minutes twice a day. Once you’re comfortable with paced respiration, you can use it when you feel a hot flush starting.
Acupuncture
Acupuncture involves placing sterile needles in specific points on the body. Some evidence suggests that it might help reduce the frequency and severity of hot flushes.
It’s important to know that if you’ve had surgery to remove lymph nodes from your armpit, you should avoid having needles in that arm or chest area due to the risk of swelling (lymphedema).
Make sure to always check with your cancer doctor or nurse to see if acupuncture is safe for you.
Hypnosis
Hypnosis may help reduce the length of your hot flushes and how severe they are. This is unlikely to be available through the NHS.
Instead, you can contact the British Complementary Medicine Association to find a registered practitioner.
Yoga
Yoga is another complementary therapy that may help manage menopausal symptoms. It combines physical postures, breathing exercises and relaxation techniques, which can be helpful for overall well-being.
Plant oestrogens
Phytoestrogens are naturally occurring oestrogens found in plants. They might support you during menopause. If you’re thinking of taking plant oestrogens or phytoestrogens, make sure to talk to your doctor.
Other ways to manage specific symptoms
If hormone therapy isn’t an option for you because of your cancer type or you don’t want to take it, there are still many non-hormonal ways to manage your symptoms:
To help you stay cool, you can try:
- Dressing in layers that you can remove and put back on easily
- Dressing in natural fabrics like linen and cotton
- Using fans like the Boots Menopause & Me Wearable Neck Fan
- Keeping your room cool at night
- Avoiding triggers like spicy foods, caffeine, and alcohol
- Using a cooling spray like the No7 Menopause Skincare Instant Cooling Mist
- Using a cooling compress like the Boots Menopause & Me Reusable Cooling Compress
- Taking cool or lukewarm showers
- Exercising regularly
- Losing weight if you’re overweight
Some people even find that cognitive behavioural therapy (CBT) can help to manage some of the physical symptoms of menopause like hot flushes.
Alongside, your GP or cancer team may be able to prescribe medicines that can help with hot flushes and night sweats. Some medicines might not be suitable for you, depending on the cancer you have and the treatment you’ve received. Your GP or cancer team can give you more information on this.
Regular exercise, like walking or yoga, can help improve your mood. Mindfulness practices, such as meditation, can also help reduce everyday stress. Talking to a counsellor or joining a support group can give you a space to share your feelings and get support.
CBT can also help you to manage mood swings and anxiety. CBT works by helping to change your negative thought patterns.
If you’re struggling with anxious feelings or mood swings, it’s important to speak to your GP for support.
You might have difficulty sleeping because of hot flushes, sweats or anxiety. These may be caused by hormonal therapies given for breast or prostate cancer.
If you’re struggling with your sleep during menopause, you can try establishing a relaxing bedtime routine and try to go to bed at the same time each night.
You should also try to avoid screen time before bed and create a calming environment in your bedroom. If you’re still struggling with sleep, you can talk to your doctor about sleep aids.
There are non-hormonal lubricants and moisturisers available that can help relieve vaginal dryness and make intimacy more comfortable.
Vaginal moisturisers that don’t contain oestrogen can be safe to use if you’ve had a hormone-related cancer. Vaginal lubricants (lube) are shorter acting than moisturisers and they only provide temporary relief. It might be worth trying different brands to see which you prefer. They’re normally applied just before sexual intercourse. Water based or silicone lube is safe to use with condoms. It’s important to avoid using anything that has an oil in it, like a lotion or oil-based lubes, with latex condoms, as it can break them.
There are also some other non-hormonal things you can try to help with vaginal health:
- If it's comfortable for you, having sex can help keep the vagina healthy by increasing blood flow and maintaining its flexibility. Using dilators or vibrators regularly can also help
- Doing pelvic floor exercises regularly boosts blood flow and helps relax the pelvic muscles. This can make sex or intimacy more comfortable and make procedures like cervical screening easier
- Avoiding irritants like heavily perfumed soaps, washing powders, fabric conditioners, toilet paper and sanitary products
- Wearing cotton underwear and trying not to wear tight clothing for too long
- Drinking plenty of water to keep your body, including your vagina, hydrated
- Quitting smoking is important because smoking reduces blood flow to the genital area
If you're going for a cervical screening and have vaginal dryness, let the nurse or doctor know beforehand so they can help make you more comfortable.
Early menopause in the LGBTQ+ community
Going through early or medically induced menopause due to cancer treatment can be a challenging experience, and it’s important to have support that understands your needs.
Everyone’s experience with menopause is different, and for those in the LGBTQ+ community, there can be additional layers of complexity, whether it’s related to identity, relationships or accessing the right care.
Taking control
You deserve healthcare that fully respects and supports your identity, no matter who you are. Your healthcare team should always use your correct pronouns and understand your individual needs.
It’s important that they listen to your concerns, especially when it comes to hormone treatments and how menopause might affect your gender identity or sexual orientation.
Support networks
Connecting with LGBTQ+ support networks can be incredibly helpful. There are online communities, support groups and organisations that provide resources specifically for LGBTQ+ individuals going through menopause. These spaces offer a place to share experiences, ask questions and receive support from others who understand what you’re going through.
For more information and resources, you can visit Macmillan’s support page for LGBTQ+ people affected by cancer, where you’ll find valuable guidance and connections to support networks.
Navigating gender dysphoria
For transgender and non-binary individuals, medically induced menopause might bring about or intensify feelings of gender dysphoria. Changes in hormone levels, body fat distribution and other physical symptoms of menopause can be distressing.
It’s important to communicate with your healthcare team about these concerns, so they can help you manage symptoms in a way that aligns with your gender identity.
Prostate cancer, breast cancer & menopausal signs & symptoms in men
Hormone therapy for prostate cancer or male breast cancer can lower or stop the production of testosterone. This can lead to symptoms like those experienced during menopause, like hot flushes or mood changes.
People affected might also experience issues like erectile dysfunction or breast enlargement.
We’ve put together advice to manage your symptoms in the ‘managing symptoms of early menopause after cancer’ section of the page. These symptoms can also affect some transgender women, non-binary and intersex people.
Menopause products
Frequently Asked Questions
Early menopause due to cancer treatment or medically induced menopause can be permanent or temporary, depending on your diagnosis and the type of treatment you receive.
If your ovaries are removed, this isn’t reversible as your ovaries are responsible for producing oestrogen, testosterone, and progesterone. When your ovaries are removed, the levels of these hormones fall immediately.
If you’ve had chemotherapy, your menopause might be temporary. This means your periods might stop and you might have menopausal symptoms, but in some cases, your menopausal symptoms can stop when you’ve finished treatment.
If you’ve had radiotherapy around your pelvis, this might damage your ovaries. This damage can be permanent in some cases.
Perimenopause is when you have menopausal symptoms but your periods haven’t stopped. This usually happens before the menopause. Early menopause is when your periods stop before the age of 45. It can happen naturally or be caused by treatment for conditions like cancer.
Being in early menopause means that you’re in menopause before the age of 45. We’ve explored more in the ‘What is early menopause?’ section of the page.
Menopause is when your periods stop due to lower hormone levels. In early menopause, the main symptom is not having your period regularly or your periods stopping completely.
If you’re going through early menopause due to cancer treatment, there are several resources available to support you.
Boots Macmillan information pharmacists are specially trained to advise you on living with cancer, including dealing with menopause. They can also provide support to you, your family, your friends and your carers. Their training allows them to understand what you need and they can guide you to more specialist sources of information and support, depending on your needs.
Boots Macmillan beauty advisors are No7 advisors trained by Macmillan and Boots to give advice to help people cope with the visible side effects of cancer. They can help you to look and feel more like yourself again.
The Boots Mental Health Hub is a great place to seek support, offering a variety of services such as talking therapies* that can be accessed on demand.
You can also try My Menopause Centre* which can be accessed through Boots Health Hub. My Menopause Centre is a specialist menopause clinic that can support with early menopause, surgical menopause or medically induced menopause through the online menopause clinic. From understanding your symptoms to personalised plans, the menopause doctors can help you navigate your way through.
For more support and information about menopause and cancer, visit Macmillan’s menopause support page or you can explore other resources on the Macmillan website.
Remember, you don’t have to face cancer alone. You can always ask your GP or specialist for further advice and support.
Menopause and the lowered levels of hormones can lead to an increased risk of some health conditions like:
• Urinary tract infections (UTIs)
Because of this increased risk, it’s important to have a healthy diet and lifestyle. You can find further advice and services about menopause on our Menopause Health Hub.
*Eligibility criteria and additional charges may apply. Any information you provide will be subject to My Menopause Centre's privacy & security policies
2Access to prescription-only treatment is subject to an online consultation with a clinician to assess suitability. Subject to availability. Charges apply.
