Premature menopause

If you have gone through premature (early) menopause because of cancer treatment, you may be bothered by frequent hot flashes, especially at night. Some women may be less interested in sex, though the decreased interest may be linked more to stress and poor sleep than to a shortage of hormones.

Female hormones in a pill or patch can help with vaginal dryness and hot flashes (see “Vaginal dryness”). But because estrogens can promote cancers of the breast, uterus, and possibly the ovaries, and cause other health problems, too, doctors are less likely to prescribe them than they once were. Women who have vaginal dryness can now use tiny doses of estrogen in gels, creams, rings, or tablets by putting them right into the vagina. These methods focus small amounts of hormones on the vagina and nearby tissues, so that very little gets in the bloodstream to affect other parts of the body.

If you have questions or concerns about hormone therapy, talk with your doctor or health care provider about the risks and benefits as they apply to you. If you and your doctor decide that hormone therapy is the best treatment for you, it’s usually best to use it at the lowest dose that works for you and for the shortest possible time. It’s important that any woman taking hormone therapy be checked each year by her doctor.

If your doctor does not advise hormones for you, hot flashes can also be treated in other ways, such as by taking medicines that control the nervous system’s reaction to a lack of estrogen. Some drugs that are commonly used this way are the anti-depressants called serotonin reuptake inhibitors, like venlafaxine (Effexor^®), fluoxetine (Prozac ^®), paroxetine (Paxil^®), and others. Many women with milder hot flashes may do well with exercise and relaxation techniques alone. There are many ways to treat hot flashes — both with medicines and with minor changes in your environment. Talk to your doctor or nurse about what may work for you.