Alternative treatment options
We understand that not everyone wishes to take HRT and for some it is not advisable.
Whether it is safe to use oestrogen if menopause is brought about by cancer will depend on the type of cancer in question. Cervical, vulval and vaginal cancer are not hormone dependent, so systemic and topical (local) HRT can safely be prescribed.
Breast cancer is considered a contraindication to systemic HRT use (meaning its prescription is not recommended); however, in some cases it can be considered in joint discussion with the woman’s oncology team. Evidence suggests that HRT can be considered in patients with a history of early stage endometrial (womb) cancer and that survival rates are not affected in women with epithelial ovarian cancer. Specialist management is always required.
For those unable to safely take HRT, and especially those below the age of 45, specialist input is paramount. Alternatives to HRT should be offered and discussed.
The British Menopause Society has a useful document detailing alternative treatments and therapies which includes:
Cognitive Behavioural Therapy (CBT)
Acupuncture
Herbal treatments
Non-hormonal prescribed medications
You can read and download this document by clicking here
For those who are in menopause due to cancer we recommend visiting menopauseandcancer.org
Dr Hannah Short kindly shared with us some really useful tips for taking care of your long-term health
“A holistic and individualised approach is required for all women in surgical menopause, whether or not HRT is used. Dietary and lifestyle measures are of great importance, both in terms of symptom control and in terms of protecting long-term health.
Key things include:
Not smoking (and seeking advice/support to help stop for those who currently do). Smoking increases the risk of osteoporosis, heart disease and dementia and can worsen menopausal symptoms.
Limiting alcohol intake to fewer than 7 units a week (around 2/3 bottle of wine) and no more than 2 units (~ 1 medium glass of wine) on any occasion. Intake of more than 7 units a week is associated with impaired brain function/cognition in later life.
Centring diet around plant-based whole foods (e.g. fruits, vegetables, wholegrains, beans, legumes, nuts & seeds) to ensure adequate intake of fibre, micronutrients and prebiotics. Evidence suggests that women who follow a plant-based diet exhibit fewer menopausal symptoms; they also have lower rates of cancer, heart disease and diabetes.
Focussing on non-dairy sources of calcium e.g. leafy greens, almonds, beans, tofu https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-and-milk/. Contrary to popular belief, dairy intake should be limited to 1 serving/day for optimum bone health.
Including regular sources of phyto-oestrogens in the diet (e.g. soya [tofu, tempeh, miso, edamame beans, soya milk], chickpeas, lentils, flaxseeds, sesame seeds). Phyto-oestrogens may improve menopausal symptoms and can have a positive effect on bone and heart health, with no negative effect on cells in the breasts or uterus (womb). In fact, regular soya ingestion may even reduce the risk of breast cancer (including recurrence): https://www.cancer.org/latest-news/soy-and-cancer-risk-our-experts-advice.html
Vitamin D3 supplementation: 1000-2000iu/day. This is especially important during the darker months (Oct-Mar).
Regular weight-bearing exercise (3-5 times/week) to maintain/build bone and muscle strength e.g. weight/resistance training, brisk walking/running, tennis, dance.
Practising Yoga, Pilates and/or Tai Chi; this can be very helpful in improving balance, core strength and posture, which becomes increasingly important to reduce the risk of falls (and, therefore, fractures) as women age.
Stress-reduction, relaxation and self-care. This is important for everyone. Consider a regular mindfulness/meditation practice, take time out in nature, or begin a new, creative hobby. Above all be kind to yourself.”