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When to expect menopause symptoms?

Page last modified on: August 28, 2008

Question from Dogzmama: I am premenopausal but will start chemotherapy and tamoxifen within 2 weeks. How soon do menopause symptoms occur? What makes some people have worse symptoms than others?: Answers —Charles Loprinzi, M.D.: Almost certainly, the chemotherapy will be given first, and the tamoxifen will not be given until chemotherapy has been completed. Thus, talking about chemotherapy-induced hot flashes, the most important determinant of whether chemotherapy will cause this problem is related to the patient's age. If a woman is less than 35 years old, then the chance of chemotherapy causing such natural hot flashes would be quite low (less than 15-20%). If the patient is closer to the age of natural menopause, then the chances of developing symptoms from chemotherapy would be much higher, greater than 80%. With regards to tamoxifen, information from post-menopausal women shows that the main issue that increases the risk of hot flashes relates to two items: first, whether the women previously had moderate hot flashes when they went through menopause, and second, whether they went through estrogen therapy. In pre-menopausal women who are not having hot flashes when they start tamoxifen, the incidence and severity appears to be less then in post-menopausal women. As far as the timing, this is something that generally takes weeks to a couple of months to occur, as opposed to days.; Mindy Goldman, M.D.: Sometimes it's hard to predict because hot flashes are so variable in many women. If you look at natural menopause, some women seem to have few symptoms while others are significantly disabled by their menopausal symptoms.

On Wednesday, August 20, 2008, our Ask-the-Expert Online Conference was called Managing Menopausal Symptoms. Charles Loprinzi, M.D. and Mindy Goldman, M.D. answered your questions about how you can manage menopausal symptoms such as hot flashes, vaginal dryness, insomnia, and more.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Charles Loprinzi, M.D. is an emeritus chairman of the division of medical oncology at the Mayo Clinic in Rochester, Minnesota. Along with hot flash management, his research focuses on ways to reduce pain as well as appetite changes caused by breast cancer treatment.

Mindy Goldman, M.D. is an OB/GYN physician specializing in the gynecology of breast cancer patients.