Menopause

Assuming you are talking about adjuvant therapy here, the answer is split into pre and post menopausal women. Most premenopausal women are asked to start on Tamoxifen but some may get an AI plus a zoladex shot (to make them postmenopausal). In that case, the advice is 5 years. If you are premenopausal and start on Tamoxifen but then become postmenopausal, you may be switched to an AI for 5 years after 5 years of tamoxifen.

For postmenopausal women, it is typically 5 years of an AI only OR it could be 5 years of an AI AFTER 5 years of tamoxifen.
Assuming you are talking about adjuvant therapy here, the answer is split into pre and post menopausal women. Most premenopausal women are asked to start on Tamoxifen but some may get an AI plus a zoladex shot (to make them postmenopausal). In that case, the advice is 5 years. If you are premenopausal and start on Tamoxifen but then become postmenopausal, you may be switched to an AI for 5 years after 5 years of tamoxifen.

For postmenopausal women, it is typically 5 years of an AI only OR it could be 5 years of an AI AFTER 5 years of tamoxifen.

One of my patients was diagnosed with breast cancer when undergoing in vitro fertilization. She went through menopause and never got a period until over a year later when she didn't really feel well and was 3 months pregnant without any help! That child is now in school and doing fine - a true gift from god. Yes, many women come out of chemo pause. Some in a few months and others longer. There is no real way to predict except to say that the closer a patient is to menopause when starting chemotherapy, the less likely she will be to come out of chemo pause. One of my patients was diagnosed with breast cancer when undergoing in vitro fertilization. She went through menopause and never got a period until over a year later when she didn't really feel well and was 3 months pregnant without any help! That child is now in school and doing fine - a true gift from god. Yes, many women come out of chemo pause. Some in a few months and others longer. There is no real way to predict except to say that the closer a patient is to menopause when starting chemotherapy, the less likely she will be to come out of chemo pause.

My period returned about 10 months after chemo had ended. The farther away from true menopause you were before chemo began, (i.e. the younger you were), the highly likelihood it would return, is what my oncologist told me. I was 45 years old when diagnosed. My mother didn't finish menopause until she was 65. If I follow in her footsteps, true menopause for me is still a ways off. As for relief during chemo, I used Black Cohosh but didn't feel like it helped me personally. Keep in mind you may begin Tamoxifen as soon as chemo ends and the symptoms may continue and have nothing at all to do with chemo and everyting to do with Tamoxifen. I found I had more vaginal dryness, shrinkage on Tamoxifen, and obviously after chemo ended this became a real problem. Other intollerable side effects on Tamoxifen caused me to discontinue it after 5 1/2 months use. Exercise, Dr. Schwartz is correct, is key to battling some of the menopausal side effects of treatment. It helped more than anything I put in my mouth. Women should use personal fans (motor-operated) to keep down the hot sweats and night sweats. They should not take any estrogen-based drug to counter these symptoms if their cancer is ER positive. Take cooler showers and eat a balanced diet with lots of vegetables, fruits, and whole grains. Keep the skin moist with some good moisturizing cream like Eucerin to avoid cracking skin. All these things do help.

I would monitor vitamin D regularly (as both vitamin D-OH25 and vitamin D 1,25). For those with cancer history, I like to see the results between 55 & 80 ng/ml. Supplement if low. Vitamin D has an impact on overall body function, cancer survival, blood sugar metabolism, thyroid health, etc. In the NY/NJ area, our latitude is too high to make vitamin D from around now through Feb/March. So, winter is an important time to check it and supplement as needed.
B vitamin complex (all 8 of them) is also important, to make red blood cells, make some neurotransmitters, help clear excess estrogen, etc. As a water-soluble vitamin, much of the B family is lost during stress. So, this should be taken on a daily basis. You need to take this with food in your stomach, or it will make you nauseous otherwise.
Omega-3 from fish/krill/ or plankton sources is another crucial supplement, an essential fat. We do not make this nutrient, and need it for many essential bodily functions. It protects the brain, forms part of each cell membrane, is a systemic anti-inflammatory and is cancer-protective. Dosage varies with need.
Depending on your thyroid situation, you may also need selenium, iodine or tyrosine. Or, if you have an autoimmune thyroid component, I would add herbs to balance immune over-response.
You might want to add a multi, some antioxidants, and a cal-mag with k. Your choice of additional supplements would be expanded as your labs indicate. As for overall well-being, I'd bring in adaptogen herbs, anti-cancer herbs/supplements as needed, to protect from overall stress, add immune-support, and all selected for your unique constitution. This could be fine-tuned based on a thorough assessment. I would monitor vitamin D regularly (as both vitamin D-OH25 and vitamin D 1,25). For those with cancer history, I like to see the results between 55 & 80 ng/ml. Supplement if low. Vitamin D has an impact on overall body function, cancer survival, blood sugar metabolism, thyroid health, etc. In the NY/NJ area, our latitude is too high to make vitamin D from around now through Feb/March. So, winter is an important time to check it and supplement as needed.
B vitamin complex (all 8 of them) is also important, to make red blood cells, make some neurotransmitters, help clear excess estrogen, etc. As a water-soluble vitamin, much of the B family is lost during stress. So, this should be taken on a daily basis. You need to take this with food in your stomach, or it will make you nauseous otherwise.
Omega-3 from fish/krill/ or plankton sources is another crucial supplement, an essential fat. We do not make this nutrient, and need it for many essential bodily functions. It protects the brain, forms part of each cell membrane, is a systemic anti-inflammatory and is cancer-protective. Dosage varies with need.
Depending on your thyroid situation, you may also need selenium, iodine or tyrosine. Or, if you have an autoimmune thyroid component, I would add herbs to balance immune over-response.
You might want to add a multi, some antioxidants, and a cal-mag with k. Your choice of additional supplements would be expanded as your labs indicate. As for overall well-being, I'd bring in adaptogen herbs, anti-cancer herbs/supplements as needed, to protect from overall stress, add immune-support, and all selected for your unique constitution. This could be fine-tuned based on a thorough assessment.

In my case,at age 47, menopausal symptoms presented itself as soon as chemotherapy was over although my periods stopped after my first cycle of chemo. I have hot flashes, vaginal dryness, and difficult sleeping. For hot flashes, I exercise regularly, eat healthy and wear layers. Bedroom windows are open all night, my husband has down comforter to help with our temperature differences. Vaginal dryness was painful and my oncologist recommended estring which works wonderfully. I occasssionally take melatonin for sleeping when I need to. Overall, my hot flashes have diminished or else I have gotten used to them. I'm so glad cool fall days and nights are upon us. That is a great question. Not doing well managing frankly. I drink a lot of water, exercise regularly, try to ensure my calcium and vitamin D intake is adequate. Hot flashes and night sweats really stink and taking a daily dose of Femara doesn't help. I tried the Chillow (chilled pillow - like the opposite of a heating pad - but it leaked all over my bed and smelled of vinyl). Cotton blankets and pj's help. Getting a decent's night of interrupted sleep has been very elusive but I'll take an occasional Ambien because it helps me sleep through the night sweats. Looking forward to hearing some other best practices on beating the menopause blues!

For women, reduced estrogen levels sometimes confuses the part of your brain (hypothalamus) that controls your body temperature, appetite, sleep cycles, and appetite. When this happens, the brain will send messages to the heart, blood vessels, and nervous system to increase blood flow, thus causing hot flashes and increased body temperature.

Hot flashes are common with women going through menopause. During menopause, a woman's ovaries produce less estrogen. This is a natural process for women as they age.

Hot flashes may also be caused medically through medications (ovarian shutdown medications and hormonal medications) or removal of ovaries.

Ovarian shutdown medications include: Zoladex (goserelin acetate), Lupron (leuprolide), and Trelstar (triptorelin)
Hormonal medications include: Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen, Evista (raloxifene), Fareston (toremifene), and Faslodex (fulvestrant). For women, reduced estrogen levels sometimes confuses the part of your brain (hypothalamus) that controls your body temperature, appetite, sleep cycles, and appetite. When this happens, the brain will send messages to the heart, blood vessels, and nervous system to increase blood flow, thus causing hot flashes and increased body temperature.

Hot flashes are common with women going through menopause. During menopause, a woman's ovaries produce less estrogen. This is a natural process for women as they age.

Hot flashes may also be caused medically through medications (ovarian shutdown medications and hormonal medications) or removal of ovaries.

Ovarian shutdown medications include: Zoladex (goserelin acetate), Lupron (leuprolide), and Trelstar (triptorelin)
Hormonal medications include: Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen, Evista (raloxifene), Fareston (toremifene), and Faslodex (fulvestrant).

Hormonal Therapy is very different from Hormone Replacement Treatments (HRT). They are almost the opposite of each other. Hormonal therapies inhibit the body's production of hormones, while hormone replacement treatments add hormones to the body.

Hormonal therapies (anti-estrogen) are used to treat hormone receptor positive breast cancers by either stopping the body's production of hormones or inhibiting hormones from attaching to cancer cell hormone receptors.

Hormone replacement therapy (HRT) refers to treatments that some women take during or following menopause that add hormones to the body. The purpose of HRT is to relieve some of the effects of menopause such as hot flashes. HRT is not a breast cancer treatment and it may increase your risk of breast cancer. Hormonal Therapy is very different from Hormone Replacement Treatments (HRT). They are almost the opposite of each other. Hormonal therapies inhibit the body's production of hormones, while hormone replacement treatments add hormones to the body.

Hormonal therapies (anti-estrogen) are used to treat hormone receptor positive breast cancers by either stopping the body's production of hormones or inhibiting hormones from attaching to cancer cell hormone receptors.

Hormone replacement therapy (HRT) refers to treatments that some women take during or following menopause that add hormones to the body. The purpose of HRT is to relieve some of the effects of menopause such as hot flashes. HRT is not a breast cancer treatment and it may increase your risk of breast cancer.

Some of the common symptoms of menopause are: hot flashes, heart pounding and racing (palpitations), night sweats, skin flushing, and difficulty sleeping.

Yes, you will more than likely experience menopause symptoms if you have your ovaries removed. Always remember each person experiences different symptoms to different degrees.

There are other symptoms of menopause which you may experience as well, but these are not as prevalent. You may see a decreased interest in sex, a little forgetfulness, irregular menstrual periods, mood swings, vaginal dryness, and joint aches. Some of the common symptoms of menopause are: hot flashes, heart pounding and racing (palpitations), night sweats, skin flushing, and difficulty sleeping.

Yes, you will more than likely experience menopause symptoms if you have your ovaries removed. Always remember each person experiences different symptoms to different degrees.

There are other symptoms of menopause which you may experience as well, but these are not as prevalent. You may see a decreased interest in sex, a little forgetfulness, irregular menstrual periods, mood swings, vaginal dryness, and joint aches.