Navigating menopause and cancer

by Dr. Catherine Multari, ND, FABNO, MSCP

The average age of menopause in Canada is 51.5 years. This number can be misleading for some as it does not account for the fact that the perimenopausal transition period can start up to 10 years prior to the final menstrual period. 

The menopause transition is a time of empowerment. When women are educated and informed about what will happen as they approach menopause, they can make informed decisions that will impact their future health. 

Perimenopause to post-menopause 

Women may begin to experience symptoms during perimenopause caused by fluctuations and decline in estrogen and progesterone. Once they officially reach menopause, defined as one year after the final menstrual period, this is where we see a steep decline in estrogen.  

There is no definitive blood test to confirm if someone is in perimenopause.  Therefore, it is best to go off of an in depth, detailed history by a menopause specialist, which should include discussion around menopausal symptoms.   

What are common signs and symptoms that occur when estrogen and progesterone fluctuate and decline during perimenopause and post-menopause?

  • Hot flashes
  • Night sweats
  • New onset sleep difficulties
  • New or exacerbated mood changes
  • Changes in sexual desire and function
  • Joint pain
  • Forgetfulness
  • Vaginal dryness
  • Changes in menstrual cycle
  • Absence of menstrual cycle (for 1 continuous year = menopause) 

It’s important to remember, most symptoms can be addressed with a variety of treatment options that can improve quality of life. 

Menopause and cancer 

Individuals facing a pre-menopausal cancer diagnosis may enter menopause well before the average age of menopause in Canada. This may be a result of the following: 

  • Certain cancer treatment medications (i.e. chemotherapy) may induce an early menopause.
  • Surgery may be required, to remove the ovaries and uterus which can induce an early menopause.
  • Individuals with a hormone-positive cancer, may be put on hormone-blocking medication, leading to an early menopause. 

Outside of the bothersome symptoms that may accompany menopause, there are also profound long-term health impacts to consider. Individuals who are postmenopausal (regardless of age) are at increased risk of cardiovascular disease, osteoporosis, dementia, metabolic syndrome and mental health concerns. 

Although Menopausal Hormone Therapy (MHT) can be helpful for many, in terms of managing symptoms of menopause and decreasing the likelihood of long-term health impacts, those facing a hormone-positive cancer diagnosis (or other contraindications) will not be candidates for MHT. 

What can you do? 

The good news is, there are many options to improve menopausal symptoms. Rooted in a healthy, active lifestyle along with preventative action, here are a few recommendations for individuals experiencing the menopause transition — with or without a cancer diagnosis: 

  • Prioritize regular exercise, with a dedicated focus on weight training and building skeletal muscle mass. 
  • Eat a healthy diet, rich in protein, fiber and a variety of antioxidants (vegetables and fruits).
  • Maintain strong social connections and engage in community.
  • Limit the amount of alcohol you are consuming.
  • Stay up to date with cancer screening (this includes PAP/HPV testing, Mammograms, FIT/Colonoscopy, and Lung CT scans for smokers or those with a history of smoking). 

At such a critical point in an individual’s health journey, I would also recommend working with a dedicated health professional trained and certified in menopause care.  

Menopause specialists can offer invaluable expertise and resources to facilitate a smoother transition.  

You can find a directory of Menopause Society Certified Practitioners (MSCPs) at The Menopause Society webpage.  

Remember, you are not alone in this journey. With support and proactive self-care, navigating menopause can be a manageable and empowering experience: the best is yet to come! 

Dr. Catherine Multari, ND, FABNO, MSCP is a Fellow of the American Board of Naturopathic Oncology and Menopause Society Certified Practitioner. Dr. Multari is practicing at AlterEgo Health.