There are several options that can be considered instead of hormone replacement therapy (HRT) for managing menopausal symptoms in breast cancer survivors. The decision depends on several factors and is highly individualized based on the patient's specific medical history and needs. Some key considerations include:
Non-Hormonal Medications and Lifestyle Changes
- Antidepressants like venlafaxine, desvenlafaxine or the herbal supplement St. John's wort may help relieve hot flashes, night sweats and mood changes
- Gabapentin can reduce hot flashes and night sweats in some women
- Lifestyle changes like staying cool, avoiding triggers, reducing stress with yoga/meditation, acupuncture, and cognitive behavioral therapy may provide relief
Vaginal Estrogen
- Low-dose, localized vaginal estrogen in the form of a vaginal cream, tablet, or ring may treat genitourinary symptoms like vaginal dryness, dyspareunia (painful intercourse), urgency, and recurrent UTIs
- Evidence suggests it has minimal to no systemic absorption or increased risk of cancer recurrence
- Types include Premarin vaginal cream, Estrace vaginal cream, Vagifem vaginal tablets
Other Hormones
- Compounded bioidentical hormones, made to match natural hormones, may be an option after thoroughly discussing risks/benefits with your oncology team
- Some data suggests testosterone supplementation in survivors on aromatase inhibitors may help energy, libido, and sexual health
- DHEA supplements may help energy, mood, sexual function - more data still needed
Natural Supplements
Some
herbal supplements like:
- Black cohosh
- Vitex / chasteberry
- Flaxseed
- Evening primrose oil
Have shown potential benefits like easing hot flashes, supporting bone/heart health. However, quality/safety standards vary greatly. Discuss thoroughly with your doctor before using.
At Balance Hormone Clinic, we specialize in customized bioidentical hormone therapy and natural supplements to relieve menopause symptoms and promote optimal health after breast cancer. Our compassionate providers partner with each patient to thoroughly assess their unique needs, risks and goals to develop an individualized treatment plan. We offer telehealth visits for your convenience. Contact us today for a consultation.
Ultimately, the decision of whether to use hormone or non-hormone treatment is complex, so have open discussions with your oncology and gynecology teams to explore all options. The most important thing is finding the right solutions tailored for your specific health status and needs while keeping cancer recovery and safety a top priority. Stay hopeful – there are more options now than ever before to help you achieve the highest quality of life possible after breast cancer.
