About This Resource
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Author: Waterloo-Wellington Regional Cancer Program
Revised: July 2016
Estrogen is a female hormone in the body. Estrogen plays a role in:
Chemotherapy or menopause can cause the lowering of estrogen in the body.
An oophorectomy (surgical removal of the ovaries leading to menopause) will cause estrogen loss/reduction.
Water based lubricants which dry out faster include: Astroglide (contains glycerin) or KY Intrigue (*not the warming version of KY), Embrace, Frixxion or personal choice (Non glycerin lubricants include: Astroglide-Naturals, Maximus, Liquid Silk, Oh My, Probe, and Slippery Stuff). The last four are found on line or in sex stores.
Silicone based lubricants Water based lubricants which dry out faster include: Astroglide (contains glycerin) or KY Intrigue (*not the warming version of KY), Embrace, Frixxion or personal choice (Non glycerin lubricants include: Astroglide-Naturals, Maximus, Liquid Silk, Oh My, Probe, and Slippery Stuff). The last four are found on line or in sex stores.
It is normal to have clear, yellow or white discharge. Use panty liners as desired. It is not normal to have bloody discharge (contact your care team if you do).
It is normal to feel different about your sexuality due to loss of estrogen. This can include: a new body image, decreased libido, a change in sexual activity. It is important if you are in a relationship for you to share your feelings with your partner so that there is no misunderstanding (e.g. your partner may be afraid to touch you in case it hurts and you might feel he or she is avoiding you).
Changes in sexuality are normal and common, so please feel free to talk about any concern you have with your health care team.
Reduced arousal, less interest in sexual activity.
Bone is living tissue made up of specialized bone cells, and like the rest of the body, it is constantly being broken down and renewed. Osteoporosis is a decrease in bone mass and bone density (bone being broken down, is faster than bone being renewed) resulting in an increased risk and/or incidence of fracture.
Women can expect to lose around 1% of their bone mineral density each year in the years beyond their menopause (postmenopausal). If healthy bones are not being maintained, postmenopausal women will most likely develop osteoporosis as they age.
The risk of osteoporosis in postmenopausal women can be further increased by family history, smoking, diet, chemotherapy, long-term corticosteroids and some hormonal therapies that lower estrogen. Women who have an early menopause (e.g. induced by chemotherapy or oophorectomy) are also at higher risk.
Women with osteoporosis may be put on specific treatment, such as bisphosphonates. In order to gain maximal effect from their osteoporosis treatment, these women need to ensure they have adequate calcium in their diet, sufficient vitamin D levels and maintain physical activity.
In general, postmenopausal women should maintain healthy bones by following the guidelines below.
Check osteoporosis Canada website for several food equivalents for calcium and vitamin D
Being physically active will improve bone mass and increase muscle strength, coordination and balance and thereby reduce falls and fractures. Weight bearing exercise is best; examples include walking, dancing, aerobics, skating and weightlifting.
Calcium and vitamin D are essential for maintaining strong bones. A daily dose is the total of what you consume from food sources and from supplements. For postmenopausal women, the recommended daily dose is 1500 mg of elemental calcium and 800 IU of vitamin D. Calcium intake from all sources should not exceed 2500 mg per day.
Please ask your doctor how much of your calcium dose should come from your diet.
If you can’t meet the recommended amounts with food alone, consider a supplement. Calcium carbonate is the least expensive calcium supplement and is well tolerated by most people when taken with food. The absorption of calcium from supplements is most efficient at doses of 500 mg or less. Some calcium supplements also include vitamin D (check the label for the exact amount.) A standard multivitamin and mineral supplement provides approximately 175 mg of calcium and 400 IU of vitamin D and other nutrients.
Adequate protein is required to maintain bone health. Include one of the following protein rich foods at each meal: meat, fish, poultry, beans, lentils, nuts, eggs, milk, yogurt and cheese.
Women, who smoke, lose bone strength faster than women who do not smoke. To protect bones, it is advisable not to smoke.
Excess caffeine and salt can have a negative effect on bone. Caffeine is found in coffee and also tea, chocolate (cocoa) and some soft drinks. For optimal bone health limit coffee to less than 4 cups per day. Foods high in salt generally include processed foods such as canned soups, snack foods, crackers, pasta and sauces. Check the nutrition label on processed foods and limit salt to less than 2100 mg per day.
Weight gain can be a normal side effect of estrogen loss (5-10 pounds or 2.3 – 4.6 kg).
Eating a balanced diet is one of the best choices you can make for overall health. You are making a positive choice, and this helps you gain back some sense of control. It also helps you feel that you are doing the best for your health.
Eating well and keeping to a healthy weight will help you to regain your strength, have more energy and have an increased sense of wellbeing. It can also help to reduce the risk of new cancers, heart disease, stroke and diabetes.
If you have not been physically active, consult with your family physician before starting.
You can benefit from regular exercise during and after your treatment. The amount you do will depend on the type of cancer you have, your treatment and generally how fit and healthy you are (30 minutes, 5 times a week is recommended).
Any exercise is better than no exercise, and even a short walk each day can help. The smallest increase in your physical activity can improve your quality of life. Exercise has been shown to help people cope with both the short term and long-term side effects of treatment.
Exercise as part of a healthy lifestyle has benefits for people who have experienced cancer.
Tobacco smoke contains at least 40 highly poisonous chemicals that cause cancer. Smoking can also cause heart disease, lung disease, poor blood flow and ulcers. Even 1 or 2 cigarettes can be harmful.
Women who smoke can have increased menstrual problems and hasten menopause.
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Overall, obesity and a sedentary lifestyle are associated with an increased risk of breast cancer. Diets that are high in vegetables and fruits may decrease risk, although the degree that they decrease risk and the specific nutrients that provide the protection are still being studied. It is recommended to increase servings of fruits and vegetables to at least 5-7 servings (total) per day for the greatest nutrient benefit. Also, alcohol does slightly increased risk and should be consumed only in moderation with a maximum of one drink per day. So, overall, the recommendation is a higher fruit and vegetable intake, less animal products (i.e. meats, animal fats, and whole milk dairy), soy in moderation, alcohol in moderation, and regular exercise to prevent weight gain and obesity. Refer to the “Diet Guidelines for Breast Cancer” for more specific information.
There is currently too little information available on the effect of flaxseed and soy on breast cancer. Phytoestrogens (plant estrogens) are present in soy foods and to a much lesser extent in flaxseed. The assumption is that the plant estrogens may bind to the estrogen receptor sites, thus preventing the body’s estrogen from binding and therefore acting as a protector from breast cancer. However, there is also the possibility that phytoestrogens may act as triggers and actually increase cancer risk. Unfortunately, the research is still inconclusive. For that reason some doctors feel that women with estrogen positive breast cancer should limit their intake of isoflavones (the type of plant estrogens in soy) until we have a better understanding of their effects on breast tumours.
Isoflavones current recommendation is to limit your intake of foods containing plant estrogens to no more than 50mg of isoflavones per day.
While soy foods in moderation can still be a part of your diet, it is recommended to avoid soy supplement powders and pills since they are very concentrated sources of isoflavones. In regards to flaxseed, it is believed to be safe in recommended amounts of 1-2 tablespoons (ground flaxseed) per day. It is also a great source of healthy Omega 3 fatty acids.
1-2 servings of soy foods is the maximum number that can be safely consumed daily.
There is convincing evidence that alcohol increases the risk of many cancers, including breast cancer. It is recommended that if you drink, to limit yourself to no more than one drink per day and no more than 3-4 drinks per week. If you don’t drink, it is best not to start.
Talk with your Oncologist if you are considering using estrogen-based medications (pill or cream).
Use this resource for your information only. It does not replace medical advice from your doctor or other healthcare professionals.
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Website: www.cancerwaterloowellington.ca