As my chemotherapy treatments continued, I began to notice symptoms of menopause appear. I became short tempered, my periods stopped altogether, and I began to have insomnia and hot flashes. This is not uncommon with chemotherapy treatments. The risk of permanent menopause for women under 40 while just being treated with Adriamycin is less than 50% according to Breastcancer.org. For others, the condition is temporary. The risk of permanent menopause is a bit higher for women on combination therapy with Adriamycin, Cytoxan, and Taxol, which were the three drugs that would complete my course of treatment. I am not sure if which side of the pendulum I ended up on due to a later surgery. For many younger women going through chemotherapy, the menopause period is temporary, and full fertility will return during the months or a few years after chemotherapy is completed.
Although spotting returned several months after my chemotherapy eventually ended, I opted for a total hysterectomy just over a year later due to the type of breast cancer I had combined with my family history of cancer and cancer related deaths. The risk was just too much of a chance to take. I want to see my sweet little girl grow up into a beautiful, smart young woman. I want to see her graduate and get married, and I want to see my grandchildren. That is worth far more than my uterus and ovaries.
Other chemotherapy treatments are also known for causing menopause. The combination treatment Cytoxan, Methotrexate, and Fluorouracil is one of these. The treatment medications paclitaxel and docetaxel have also been linked to early menopause. For some women, the menopause is permanent, for others, the symptoms will ease and their fertiility will return anywhere from months to a few years after their treatments are complete. The treatment you are on is not the only factor in whether or not you are at risk for experiencing early menopause due to your chemotherapy treatments. Other factors include age, dosage, length of treatment, family history, smoking history, and body mass index.
Although menopause during chemotherapy is common, it isn’t guaranteed. Many women continue to ovulate through chemotherapy treatments, even once their periods become irregular. The Cleveland Clinic advises women of childbearing age to take careful precautions to avoid pregnancy while receiving chemotherapy treatments, even if they have menopausal symptoms, including irregular periods. Birth control should be continued for a minimum of 4 to 8 weeks after chemotherapy treatment is complete. Depending on the type of cancer a woman is being treated for, such as in the case of breast cancer, hormonal contraception like birth control pills may no longer be advisable. In this case, barrier methods like condoms and diaphragms, used in combination with spermicide, is the suggested contraceptive route.
If a woman becomes pregnant while receiving chemotherapy treatments, it is critical for the health of the baby that she notify her oncologist immediately. It is rare for this to happen, but it is possible. Pregnancies that occur during chemotherapy are often complicated and require extra care and observation. Continued chemotherapy treatments during the pregnancy can result in undesired effects on the baby’s development.
I don’t regret having decided to have a hysterectomy. I really didn’t have any onset menopause symptoms, which is why I believe my menopause did occur with the chemotherapy. I had about five good weeks of needing an air conditioner in my bedroom at night…but it was also July and August in the Deep South during a very HOT summer. Since then, as the weather cooled down, my body temperature did too, and now I am just as I was before surgery, which is cold most of the time. Very rarely do I have a hot flash. It was good to be prepared going into it, though, knowing what could come afterward. Having already gone through it during the chemotherapy, I was prepared for the worst. What I ended up with was so much better.