Surgical menopause at 41 - recommendations for good literature?

Fedders

Hi everyone,

I'm looking for recommendations for good books on menopause, particularly on topics like recommended nutrition and exercise regiments, dealing with and overcoming side effects of menopause at a young age, etc.

I'm 41, was diagnosed with stage 2B, grade 3 ER+/PR+ HERC- BC with an oncotype score of 47 earlier this year and have gone through chemo and a lumpectomy. Next on the agenda is radiation (starting in a few weeks) and a salpingo-oophorectomy which I'm having in two days (followed by an aromatase inhibitor when I'm done with radiation). My mom was 57 when she went through menopause so I was utterly unprepared for having to go through it at 41. I'm mostly concerned with the more permanent physical changes (low libido, possible osteoporosis, weight gain, skin/hair/nails, etc) so I would love to find some good resources with recommendations on diet, exercise, supplements, etc.

Any recommendations would be appreciated! And if anyone else has gone through menopause at an early age, I would love to hear about your experiences as well.

Thank you!

NikJ

Hi Fedders, I had a salpingo-oopherectomy back in March of this year. Family members made it sound to me like surgical menopause was hell. To be honest, after I healed from the procedure I have never felt better!! It made me realize how my hormones were giving me such problems the last few years. I had night sweats only once in a while, did not gain weight because I workout, and believe it or not intercourse improved. Unfortunately, once I started on my AI (about 2 months later) the side effects made me feel terrible. I'm currently in the process of changing to a different AI. Not everyone gets sides effects from AI's but I've always been very sensitive to medication. I wish you the best of luck with your procedure.

Fedders

Hi NikJ,

Thanks so much for sharing your experience. That makes me feel hopeful! It's difficult to know what to expect since everyone mentions hot flashes, weight gain, vaginal dryness and loss of libido (all the fun stuff - or not so much). Just like chemo, I know it's different for everyone and my system has held up pretty well so far so I don't want to assume the worst. The women on both sides of my family haven't typically had many symptoms of menopause as they were going through it so I'm hopeful that this will be the case for me as well.

I'm sorry you're having trouble with the AIs. I believe my oncologist wants to put me on Arimidex, if I remember correctly. Is that the one you're on? Hope it's resolved by switching to a different kind!

msphil

yes sweetie I was diagnosed at 42 while planning our 2nd marriages this was in 90 s and wasn't told bout early menopause found out hard way on my own. Along with all other emotions after diagnosis also cause of menopause too rough time But I am now a 24yr Survivor Praise God and was glad that I went thru it then realized best thing happened out of it All No more periods. With Hope Positive thinking and course my Faith in still here to Encourage others to Hang in there You Can this too. .msphil idc stage2 0/3 nodes 3mo chemo before n after Lmast got married then 7wks rads 5yrs on Tamoxifen

Meow13

Was the oncodx score for dcis or idc? Take care.

Fedders

Hi Meow13,

I had both DCIS and IDC so I suppose it was for both? I only got one score so I think that covers both.

SpecialK

fedders - your score was for the IDC. OncotypeDx is for determining whether chemotherapy added to anti-hormonal therapy provides any benefit - and this information does not apply to pure DCIS. The treatment for IDC trumps the treatment for DCIS. There is a separate test for DCIS called OncotypeDxDCIS that is done for those who have DCIS only - no invasive component, that helps determine future risk of recurrence and treatment decisions for patients who have DCIS only. Also, wanted to add that I had a total abdominal hyst/ooph at 45 for very symptomatic numerous uterine fibroids, nine years prior to diagnosis of breast cancer, and I found it to be a relatively easy recovery without too much impact on daily life (my kids were in middle school), with hot flashes my only symptom - no mood swings, no weight gain, or other issues.

Fedders

Hi SpecialK,

Great to hear that your recovery after the oophorectomy was relatively uncomplicated. It has been a week today since I had my salpingo-oophorectomy and I feel pretty good overall. I had about 6 weeks of intense hot flashes just after I wrapped up chemo but so far I'm not feeling anything in terms of hot flashes, mood swings, etc. So far so good!

How have your side effects from the aromatase inhibitors been?

SpecialK

fedders - I have had some relatively minor issues with aromatase inhibitors over the 7 years I have been taking them, but nothing that would make me stop. At diagnosis I had osteopenia, then worsened density from chemo and the first 6 months of aromatase inhibitors, so needed Prolia injections to strengthen my bones. I likely would have needed this even without a breast cancer diagnosis since I fit the likely physical profile, and was already nine years out from hyst/ooph. Prolia has been great, much improved density, zero side effects. I initially started on Femara, as my oncologist likes it for my subtype, and within six months I had a trigger joint in my thumb - this is relatively common. He suggested I switch to Arimidex, so I did and the trigger went away. Other than some stiffness that is remedied with movement/exercise, no problems until about 18 months in. Developed more triggers and a sore knee. Had a cortisone shot into the knee (had bumped it on a trailer hitch and it produced an inflammatory response), which fixed that problem, and switched back to Femara. This time I used a different manufacturer and had less problems with stiffness and trigger joints. I would recommend that if you experience joint stiffness or pain, definitely keep up with exercise, but also try using a different manufacturer of the first drug, or switch drugs - this is often a trial and error process until you find the one that causes the least side effects. This is not the same for everyone - what you use may cause issues for another patient, so there is no one best drug or maker, but I have found that researching online to find the drug with the least additives has been key. Also, there is a direct access program to get the brand name Arimidex from the maker - for some, the original formulation, not a generic, makes all the difference but often insurance will only cover the generic. I believe the Arimidex program is a mail order/no insurance program, but it is $30/month - which is not bad. There are a number of members who use that system on this site and have been happy with it. Have a bone density scan done now so you have a baseline after your surgery, and have your oncologist monitor your vitamin D level - many breast cancer patients are low. Talk to your oncologist about vitamin D supplementation, if needed, and calcium supplementation, and make sure you incorporate weight bearing exercise to help maintain bone health - the loss of estrogen can have a big impact especially if you are younger at loss of ovaries. Glad you're doing well!

Fedders

Hi SpecialK,

That's really incredibly helpful! Thanks so much for the lengthy response.

I had a bone density scan just before I had my ovaries out and I'm perfectly average at this point. My OBGYN talked to me about calcium and vitamin D through diet and I've started taking citracal and vitamin D supplements. I've always been quite active even though the past six months have brought my fitness level down significantly but I'm making it a priority to get back into a strength-building exercise routine. I'm glad to hear you haven't had any issues with Prolia. My OBGYN suggested that I 'negotiate' with my oncologist to hold off on my first Prolia treatment until a year after my oophorectomy so we can do another bone density scan first. I would prefer not to have Prolia if I don't need it. But if I do, I can certainly live with that.

Also, thanks for all your feedback about AIs. It's good to know that the side effects may vary between manufacturers. I believe my oncologist wants to put me on Arimidex. I'll monitor what the side effects are and talk to him about switching if I'm not doing well on what I'm taking.

Thanks again .

SpecialK

fedders - of course! Glad to see that you had a timely DEXA, and that you are on top of supplementation and exercise. Prolia is also thought to help protect against bone mets by making the bone a less hospitable environment by increasing density - so that is a bonus if you should need it. There is also a relatively new thread on this site that I will link below about people who are on AI drugs and managing well.

https://community.breastcancer.org/forum/78/topics/854403?page=1