Menopause symptoms after cancer

The Menopause Symptoms after Cancer Clinic at the Women’s was introduced in 2010 to help care for women who experience menopause symptoms after cancer treatment.

After cancer treatment, troublesome menopausal symptoms are common for many women and include hot flushes, night sweats, loss of interest in sex, difficulty sleeping, fatigue and extreme vaginal dryness.

Based on years of practical experience, national and international research, the Women's determined that a real need existed in Victoria to develop a multi-disciplinary Menopause Symptoms After Cancer (MSAC) Clinic to treat the impact of menopausal symptoms and quality of life in female cancer survivors.

The safe and effective management of menopausal symptoms after cancer is a considerable clinical challenge. Yet the management protocols developed by the Women's in the MSAC Clinic have been recognised in Australia and around the world as excellent examples of patient-centred care for a group of women with very distinct healthcare needs.

The Clinic has a specialist team of gynaecologists, endocrinologists, psychiatrist, psychologist, sexual counsellors and specialist nurses to provide a multidisciplinary approach to care to women from across Victoria.

It is the only clinic in Victoria where menopause, mental health and cancer co-exist

Health issues treated

Professor Martha Hickey, an internationally recognised gynaecologist specialising in menopause, is the director of the MSAC Clinic. She said cancer survivors have twice as many hot flushes and were twice as likely to report severe or very severe flushes than non-cancer patients.

Cancer treatments, including surgery, chemotherapy, radiotherapy and endocrine therapy may cause a woman’s periods to stop, trigger hot flushes, night sweats, vaginal dryness and mood changes.

For younger women, these symptoms may be distressing as it may have been some years before their natural menopause would have occurred. Also, these symptoms may cause concern about the impact on fertility, the safety of available treatments and the quality of life.

Some women, particularly those with a breast cancer diagnosis, may be advised to stop using hormone replacement therapy (HRT) by their cancer specialist. This is where the MSAC Clinic can provide support and advice to women should menopausal symptoms return. 

What we do

Some cancer treatments - chemotherapy, some surgeries, pelvic or whole-body radiation - may cause menopausal symptoms. These symptoms can be distressing, and in some cases, persist for a long time after treatment has ended. Younger women with cancer may experience these symptoms many years before they expected to and older women, who may have already been through menopause, could experience menopausal symptoms all over again, years after they first subsided.

Some women who do not have cancer, but who are at high risk, may want information about menopause because they are considering risk-reducing preventive surgery to remove the ovaries (oophorectomy).

A specialist nurse, with experience in menopause after cancer, is available to offer support and information to all women attending the MSAC Clinic.

The MSAC Clinic offers advice on:

• medical therapies to alleviate menopausal symptoms;
• lifestyle factors such as exercise and nutrition;
• sexual counselling; 
• fertility after cancer treatment;
• cardiovascular health
• bone health

The MSAC clinic also works closely with:

• The Familial Cancer Centre, The Royal Melbourne Hospital (RMH)
• Bone Marrow Transplant Services (RMH)
• Specialist Fertility and Reproductive Services at the Women's
• The Women's Centre for Mental Health
• The Breast Service (the Women's and RMH)

The Clinic offers advice on medical therapies to help alleviate menopausal symptoms, information on lifestyle factors such as exercise and nutrition, sexual counselling and fertility after cancer treatment.

There is also expert information specific to women’s unique health needs on mental health, heart and bone health.

At the Women's Menopause Symptoms After Cancer Clinic women will see a gynaecologist and clinical nurse specialist who are experts in menopause.

They will talk to a multidisciplinary team about treatment to develop individually-designed menopause care that is safe and effective.

Information for patients

Your first appointment

After you have been referred to the Menopause Symptoms After Cancer Clinic by a doctor or treating team of health care providers, you will receive a letter from the Women’s with an appointment time and date. We understand that women are sometimes unable to attend appointments, for a variety of reasons.

At the MSAC Clinic we are committed to providing women with the best possible care and are aware of the difficulties faced by women with menopausal symptoms after cancer.

If you are unable to attend your appointment, or need to change the time, please contact the Clinic as soon as possible so that we can make another appointment for you.

Treatment options

There are a range of options for treating menopausal symptoms. However, for women with a cancer diagnosis not all treatments are suitable or recommended. The Women’s has developed evidence-based guidelines to provide safe and effective treatment of menopause symptoms after cancer.

Our multidisciplinary team can advise on the most appropriate treatment options for you. The team works together with women to develop individualised care plans which take into consideration each woman’s circumstances, cancer diagnosis and menopausal symptoms.

Referrals	Your doctor/GP will need to fax a referral before you can come to this clinic. For more information, see: Referrals. A referral is valid for 12 months.
What to bring	Your test results (including any scans) Your Medicare card Health Care card (if you have one) The date of your last Cervical smear test A list of any medications you are now taking We have a copy of your referral already.

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