Late Onset Menopause (after 55) Post-Tamoxifen

Rosamond

My primary doc freaked about my having two periods in one month at the age of 55. I didn't get my first period until I was over age 15, and my mother had late onset menopause as well. I know that late onset is another risk factor for BC, but my only other risk was having my first and only child at age 40. No genetic or family risk factors, and my tumor was quite small and weakly positive for HER2neu, so no herceptin but 5 years of tamoxifen, which I ended this past September. I have had mild to typical periods all the way along post-BC, but they have not always been regular. There have been many months between them, at times, and they were mostly very light in the last year or so until May, when I had 2 moderate but not overly heavy periods with mild cramping.

I had a transvaginal U/S which came back with no malignant findings. However, there is a cyst on a Fallopian tube and some thickened lining. Doc referred me to an OBGYN for endometrial biopsy.

I would really like to avoid a hysterectomy for many reasons, but the major one is that my husband was recently diagnosed with the most horrific of stage 4 brain cancers, a glioblastoma (think Ted Kennedy, Beau Biden, John McCain) and he will soon need my assistance. When it rains, it pours.

Anyone else have anything similar, or late onset menopause? My oncologist didn't seem concerned about those periods at age 55, but my primary survivorship doc is freaking out. Thoughts?

AliceBastable

I was 58 when I had a hysterectomy, and my GYN said tests showed no signs of approaching menopause. I had a smallish endometrial cancer and when I questioned the necessity for a total hysterectomy, the oncologist asked if I was trying to get in the Guinness Book. He was pretty funny. My Mom didn't go into menopause until she was 59, so I guess it's genetic. We both wound up with breast cancer later, so our bodies must keep churning out hormones, mine without any equipment.

The hysterectomy wasn't bad - I stayed in the hospital one night. If you can have help the first week or so, you should be able to manage. Just no heavy lifting, but being active actually helps. I wasn't active enough, and got "swelly belly" as a result - it took weeks to resolve. But otherwise, healing was pretty easy. I had a comparable surgery last year (nephrectomy) and had a much faster recovery because I walked a lot.

Rosamond

Thanks @AliceBastable!

farmerlucy

I had a hysterectomy at 56 ? after have been on Tamoxifen, and AI after an ooph. So the sequence was Tam, ooph, AI, Tam, hyster. I had post meno bleeding and quite frankly I was sick and tired of seeing my gyn so often. I had a total open hysterectomy, and beside the first night of pain it was not that bad. I have no idea why I put it off so long. Also since the uterus was enlarged I had some issues with incontinence before surgery which improved dramatically after the hysterectomy. That alone made the surgery worth it.

I’m so sorry about your husband’s dx. Argh. FU cancer.

AliceBastable

Oh, btw, my 2008 hysterectomy was robotic with five tiny incisions. MUCH easier than healing from a large slash. Same with last year's nephrectomy. But add in the lumpectomy and hip replacement, and I look like I've been on the losing end of some street fights.

TwoHobbies

Rosamund, I had the uterine thickening on tamoxifen and the biopsy was normal, so it does not necessarily mean anything. I hope you will find the same. I do think menopause is genetic. I am 58 and have low estrogen but FSH has notrisen indicating menopause. My mom said she hit menopause late 50s. I am glad to find a couple of other anomalies out there!

edj3

Yeah I started menopause at 55, guess I blinked and missed it because it's done at 59!

jojo9999

Sorry to hear about your situation. I was on tamox bc I hadn't gone through menopause at dx (51 yo). The tamox slowed but didn't completely stop my periods and it spiked my estrogen levels, probably due to the large cysts that grew on my ovaries. FYI: estrogen tests while on tamox aren't completely reliable. So after 2.5 years, I stopped tamox and got two horrible periods over the next 3 months - I opted for ovary removal (instead of suppression) so I could start an AI. Like you I did not want the big operation of a full hysterectomy and uterus looked ok. The operation (oophorectomy with a D&C to check utuerus) didn't require a hospital stay, recovery very easy - no heavy lifting for 2 weeks. I thought it was a good compromise. Good luck to you and your husband.

Rosamond

UPDATE: A biopsy of my endometrial lining, which was quite thick (19.5mm) was NORMAL. Benign! So, no surgery or procedures for me in the near future. As of this writing, my husband is responding well to his initial treatments and has no discernible symptoms. Hoping he lives with a good quality of life for as long as possible, and, when things take a turn, that they are mercifully swift. Thanks to all for the support.

farmerlucy

((Rosamond)

edj3

So glad your results were normal, Rosamond--you've got more than enough going on.

TwoHobbies

Good news on both fronts, Rosamond!