I was hit by menopause symptoms after my first chemo session

Dee O'Grady was 39 when her treatment for breast cancer resulted in profuse sweating, joint pain and forgetfulness

Dee O'Grady, from Clontarf, Dublin. who has undergone treatment for breast cancer and attended ARC's cancer support centre.

In 2021, Dee O’Grady from Clontarf was working as head of content and digital production at Brown Thomas. She had no idea that her busy life was about to be upended by cancer.

“I had breast pain but because I was 39, I never suspected cancer,” she says. 

“But I wanted to rule it out so I made my GP refer me for a mammogram.”

That mammogram and subsequent tests found cancer in both her breasts and O’Grady then underwent months of chemotherapy, surgery and radiation. She expected those to take a toll but was unprepared for the intensity of one of the side effects.

“I was hit by menopause symptoms immediately after my first chemo session,” she says. 

“I’d been warned it could happen but wasn’t ready for the severity of it. I was instantly drenched in sweat and had joint pain that made me feel I’d turned into an old lady overnight. 

"I became forgetful and so disorientated that it was difficult to drive a car. 

"It felt doubly cruel having to deal with cancer and the sudden onset of menopause.”

Her medical team were focussed on her cancer treatment and unable to provide her with the help she needed to tackle her menopause symptoms, so she went online.

“But because cancer treatment had thrust me into a medically induced menopause, a lot of what I found there wasn’t applicable to me. 

"For example, I couldn’t take HRT because of my hormone-sensitive cancer. I wished there was a place where I could have found information that was relevant to me and what was happening to my body.”

Gap in support

That place is currently being created by ARC Cancer Support Centres, which have been supporting people with cancer since 1994. ARC recently launched an online survivorship programme for women whose cancer treatment has brought on early menopause or a resurgence in menopause symptoms.

“Women who experience these menopausal symptoms can be very distressed yet they have had very little support available to them to date, either in Ireland or internationally,” says Yvonne Lucas, head of services at ARC.

That gap in support has been further highlighted by the growing public conversation about the impact menopause can have on women. 

“Women impacted by cancer have told us that they feel excluded from this conversation,” says Lucas. 

“Much of the information simply doesn’t apply to them. That’s why we have designed our programme to provide evidence-based advice on interventions that can work for them and peer support from others who share their experience.”

Dr Deirdre Lundy is a women’s health specialist who leads Ireland’s first publicly funded menopause clinic in Holles Street, Dublin. 

She explains how cancer treatment can cause early menopause. 

“If the cancer is in the ovaries, then treatment will affect how the ovaries perform and the release of oestrogen, which can lead to premature menopause,” she says.

“Even if the cancer is elsewhere, many treatment options such as chemotherapy or radiotherapy to the pelvis can affect the ovaries. 

"Also, the treatment for hormone-sensitive cancers often involves suppressing all the hormones in the body in order to starve the cancer of oxygen.”

Not all oncology teams can help women navigate early menopause alongside cancer treatment. 

“Some women have great teams who explain their options and talk them through possible side effects,” says Lundy. 

“Others are merely advised to go to their GP with any problems.”

This approach angers Lundy. 

“Women undergoing cancer treatment are exposed to potentially dramatic symptoms and side effects,” she says. 

“It’s our duty to prepare them for what might happen and what they can do about it.”

Women who go through medically induced menopause can experience a range of symptoms that vary in severity, just like women who experience menopause naturally. 

“Whether or not you suffer with symptoms depends on the type of cancer you have, the type of chemotherapy, where any radiation treatment is directed and simply the luck of the draw,” says Lundy.

Common experiences

While the severity of symptoms may differ, many of these women share common experiences. One is feeling isolated.

“They are going through something that others their age are not going through,” says Lundy. 

“Generally, menopause is a gradual process, whereas theirs can be an overnight transformation. Few people can relate to that.”

O’Grady’s experience echos this.

“I’ve got great friends and family and had lots of chats with them about cancer and menopause, but my situation was so different to theirs,” she says.

Women experiencing medically induced menopause can also struggle with a sense of loss. 

“There can be different psychological and emotional losses to deal with,” says Lucas. 

“There may be a loss of fertility and ability to have children. Their relationship with their partner can change. They might not be able to return to work. 

"Or they might not even recognise who they are anymore.”

O’Grady says menopause made her feel like an “entirely different” person. 

“I tried to get back to that person and it took me a while to realise that wasn’t going to happen. I had to accept my life had changed and so had I.”

Women with cancer can also feel they are not entitled to complain about menopause symptoms. 

“I’ve heard them say they feel they have already used up their sympathy quota,” says Lucas.

“People were willing to listen to them talk about their cancer, but they find the menopause harder to relate to. 

"Yet the cancer will ultimately be treated while the menopause symptoms may linger for years. These women need help.”

That help will be offered in ARC’s new programme, which will be delivered online over eight weeks.

It will feature experts such as Dr Lundy, who will cover topics ranging from how to identify and treat menopause symptoms to lifestyle supports such as nutrition and exercise, issues around intimacy and sexuality and optional sessions for partners.

“Every session will have an expert contributor who is a medical doctor or professor working in the area,” says Lucas. 

“There will also be an opportunity to break into smaller groups to discuss issues with a psychotherapist.

“After each session, women will be provided with a summarised list of tips and advice, including information about medical interventions for their GP or medical team. 

"We aim to give women the most up-to-date medical information about medically induced menopause along with support from their peers who are going through the same experience as they are.”

Such a programme would have made a huge difference to O’Grady, now 41. 

“There are so many things that are beyond your control when you have cancer,” she says. 

“You’re so anxious. This programme will give women reassurance when they need it most and give them back a sense of ownership over their bodies.”

There are currently 35 women enrolled in the first of these programmes, which started on January 23.

“The next will take place in April, and we’re hoping to have helped 150 women by the end of this year,” says Lucas.

“We would like this programme to be rolled out nationally eventually and
for women all over Ireland to have access to the help they need.”