Menopause is a natural life passage for all women - but it may come sooner, or feel stronger, for breast cancer patients. When a premenopausal woman starts chemo, she may not know it, but the drugs may send her into medical menopause at top speed. She may start having classic symptoms of "The Change," before she's ready! Menstrual periods may cease (sometimes this is temporary), and mood swings, trouble sleeping, vaginal dryness, low libido, and fatigue may set in. Most us expect the terrible twins of menopause -- hot flashes and night sweats -- but when these symptoms rudely tag along with side effects of chemo and hormonal therapies, it can all seem just too much! Women who are already in menopause may start having increased hot flash and fatigue symptoms during chemo or Tamoxifen therapy - how unfair is that?
How nice it would be, if we could just wish it away - the cancer, the treatments, and those pesky hot flashes. Well, I would take classes in "Wishing Therapy" if that would do the job, but it seems there is something more effective. Cognitive-Behavioral Therapy (CBT) does help tame the symptoms of menopause in women who have been treated for breast cancer. Two studies have just been published by a group of researchers in Great Britain on the success of CBT on menopausal symptoms. The studies are called MENOS 1 and MENOS 2 and both were led by Professor Myra Hunter from the Institute of Psychiatry at King's College London. Cognitive-Behavioral Therapy is a safe, psychotherapeutic technique that employs a support group setting, talk therapy, self-discovery, and changes in behavior. There are no drugs to take, most importantly - no hormones involved in CBT. That's very important for those of us who were diagnosed with estrogen-positive breast cancer - we can't take hormone replacement therapy to make up for lower estrogen levels.
In each study, participants were divided into groups. Some groups were given professional instruction in CBT, another group was given a self-help manual for CBT, and another group was wait-listed (no therapy given). All participants were evaluated at the end of therapy and six months later. Women who had any Cognitive-Behavioral Therapy - regardless of how they received it - reported benefits such as: less intense hot flashes, lower stress levels, more optimistic view, better self-esteem, improved sleep and more positive perception of their body image. The women who had no CBT reported no improvements in their menopausal symptoms.
Cognitive-Behavioral Therapy could be used along with a healthy diet and a regular dose of exercise to speed recovery from breast cancer treatments or from natural menopause. Just keep in mind that as with any psychotherapeutic program, you must be willing to take a good look at your own habits, make some changes, and stick to your new, healthy resolutions. Having some accountability and even a buddy involved might boost your odds of making CBT work in your favor, and put your hot flashes on ice!
Source: Ayers B, Mann E, Hunter MS. A randomised controlled trial of cognitive-behavioural therapy for women with problematic menopausal hot flushes: MENOS 2 trial protocol. BMJ Open 2011;1:e000047. doi:10.1136/bmjopen-2010- 000047
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