Coping with Estrogen Loss

Bone, muscle, and joint discomfort is a common side effect of many anti-hormone medicines. You might feel this in your hands, knees, back, hips, or shoulders. If you ever think about stopping your hormone therapy because of these symptoms, talk to your healthcare team first.

Helpful Tips

• Try to do light to moderate exercise 30 minutes, 5 days a week.
• Talk to your pharmacist or healthcare team about over-the-counter pain medications. They may be helpful and safe for you to use.

Hot flashes can make you feel extra hot or sweaty.

Helpful Tips

• Quit smoking
• Manage stress
• Exercise 5 days a week for at least 30 minutes
• Dress in layers or light materials like cotton, rayon, and linen
• Avoid food triggers such as; hot foods, spicy foods, caffeine, and alcohol
• Avoid hot tubs, saunas, hot showers if these trigger a hot flash for you

You may notice changes to your mood as your estrogen levels change. You may be at higher risk for anxiety and depression.

Helpful Tips

• Eat a balanced diet; reduce caffeine
• Exercise 5 days a week for at least 30 minutes
• Stress reduction: yoga, massage, deep breathing, and favourite hobbies
• Talk to your family doctor about mood support medicine

Estrogen loss may make it harder to remember small, everyday details.

Helpful Tips

• Use your mind daily e.g. reading, game playing, attend lectures
• Write things down (Make lists or charts, cell phone reminders, journaling)
• Eat a healthy, balanced diet

Loss of estrogen can cause a change to your sexuality (sexual feelings, thoughts, attraction toward others) or intimacy (being close with another person). These changes can affect your quality of life and relationships. This may not seem like a big deal, but it’s an important part of your well-being. Talking about these issues may feel hard, but your healthcare team can help.

You might notice:

• Changes to your body image
• Lower libido (less interest in being intimate and having sex)
• Physical changes during sex (like dryness and the need to use lubricant)

Helpful Tips

• Talk about physical or emotional changes with your partner
• Try new ways of being intimate
• Talk about your mood with your partner, family, or friends
• Learn more through the University Health Network’s sexual health resources
• Talk to your healthcare team about a referral the a Sexual Health Clinic for people with cancer

Changes to your vagina can happen as estrogen levels change. This can include dryness, discharge, thinning, or inflammation of the vaginal tissue.

Dryness
To moisturize to the vagina, talk to your pharmacist about how to use products like Repagyn® and Replens®. Before using an estrogen-based medicine talk to your Oncologist. For sexual purposes you can use water or silicone based lubricants (lube) that can be bought at the pharmacy, online, or in sex stores.

Vaginal Discharge
It is normal to have clear, yellow, or white discharge. You can use a pad or underwear liner if needed. If you have any bloody discharge tell your healthcare team.

Radiation Vaginal Changes
If you are getting radiation treatment that affects the vagina it may lead to vaginal dryness and thinning. Your radiation team will give you more information about how to manage these side effects.

Eating a balanced diet is one of the best things you can do for your health. You are in control of your food choices, and your food choices can affect how you feel.

Eating well and staying at a healthy weight will help you to build up your strength, have more energy, and feel better overall. It can also help to lower your risk of new cancers, heart disease, stroke, and diabetes.

Eat these foods as part of a balanced diet:

• Fruits and vegetables
• Whole grain products
• Dairy products (milk, greek yogurt, kefir, cottage cheese)
• Protein (chicken, fish, eggs, beans, lentils, or nuts)

Refer to Canada’s Food Guide for more information on portions and food choices.

Natural health products include herbal remedies, vitamins or mineral supplements, homeopathic medicines, or traditional medicines.

Cancer treatments try to damage cancer cells while trying not to hurt healthy cells. Natural health products may change how your treatment works and targets cancer cells. They may even make side effects worse, or affect other health conditions. Information on natural health products during cancer treatment is always changing.

Tell your healthcare team if you are currently taking any natural health products. Also, talk to your healthcare team before starting any new natural health products.

Alcohol raises your risk of getting many cancers, such as breast cancer. If you drink, limit to no more than 1-2 standard drinks (12 ounces of beer, 5 ounces of wine, 1.5 ounces of spirits) per week. If you don’t drink, it is best not to start.

Smoking can affect your body’s ability to heal and process medicine. Smoking can also cause heart disease, lung disease, poor blood flow, ulcers, and other types of cancer. Even 1 or 2 cigarettes can be harmful. If you are interested in quitting smoking, please talk with your healthcare team or family doctor.

Weight gain can be a normal side effect of estrogen going down (5-10 pounds or 2.3-4.6 kilograms). Regular exercise and diet changes can help maintain and manage a healthy weight.

Exercise can help you have energy and stay strong during and after treatment. Any exercise is better than no exercise. Even a short walk each day can help. If you are not currently active, talk to your family physician before adding new exercises.

Exercise can help manage:

• Fatigue or tiredness
• Anxiety, depression, and sleep problems
• Weight gain
• Stress
• Bone thinning

As you age, you lose bone mass and density (how hard your bones are). In menopause you can lose 1% of your bone mineral density each year. This can put you at higher risk for osteoporosis (where bone cells are lost faster than the body can remake them).

To keep your bones healthy while on hormone treatment, you will need to take enough calcium and vitamin D. Refer to Osteoporosis Canada’s Calcium Calculator to learn more about food sources.