The Connection Between Early Menopause and Breast Cancer

There is a common misconception regarding the connection between menopause and breast cancer – though the two are often linked, the fact is that menopause does not cause breast cancer. Certain treatment options, however, may contribute to the onset of premature or early menopause. Additionally, women that experience the menopause transition later in life may be at higher risk for developing breast cancer.¹ Those who use hormone replacement therapy for managing menopause symptoms may also have a slightly increased risk.²

Here, we discuss the potential correlation between breast cancer, treatment options, the link to menopause and lifestyle changes to consider to support better health.

Keep reading to learn more.

How Does Age Affect Breast Cancer Risk?

Though there may be positives of going through menopause later in life, the fact is, the older you are, the more exposure you’ve had to estrogen throughout your lifetime. Estrogens are a group of female sex hormones that stimulate the development breast tissue and are known human carcinogens – they can be associated with an increased risk of breast cancer along with other cancers.^3,4

Studies have shown that each additional year you age – meaning the older you are when reaching menopause – the risk of breast cancer increases by 3%.⁵ In one recent study, women whose menopause experience begun at age 44 or younger, noted a 34% lower risk of breast cancer than women with a menopausal onset age of 55 years or older.⁶ 

Hormone Therapy Use and Potential Breast Cancer Risks

For those women that are utilizing a combined systemic hormone replacement therapy (or menopause hormone therapy) – one that includes both estrogen and progestin to manage their menopause symptoms – they may experience a slight increase in their risk of breast cancer.⁷ Women who are taking estrogen alone for this same reason, which is typically reserved for those without a uterus,  may also still be at risk for conditions like endometrial cancer.⁸ Weighing the risks vs. benefits of symptom management solutions is paramount. When seeking symptom management options during menopause, it’s important to discuss any questions or concerns you may have with your healthcare provider to decide on the right option for you.

Breast Cancer and Premature Menopause

There are quite a few treatment options available for breast cancer, though they may come with some unwanted side effects. Numerous studies have shown that a selection of treatments for breast cancer may cause women to experience premature menopause, along with its related symptoms.⁹ “The purpose of many of these treatments for reproductive cancers is to literally deplete the body of as much estrogen as possible in an effort to prevent the cancer from recurring,” explains Bonafide Chief Medical Officer Dr. Alyssa Dweck.  Because of this, certain treatments for breast cancer can result in symptoms commonly experienced during menopause, like hot flashes, night sweats, disruption of sleep patterns, anxiety, mood swings, brain fog and vaginal dryness. ¹⁰

Breast Cancer Treatment Options and Their Impact on Early Menopause

In general, there are multiple treatment options for breast cancer, and most regimens include a combination– they often include: surgery, chemotherapy, radiation, hormone therapy, or targeted therapies.¹¹

Chemotherapy

With chemotherapy, for example, there are some versions of medication that may be more likely to cause menopause symptoms than others – such as cyclophosphamide – although any type of chemotherapy can contribute to the onset of early menopause symptoms.¹² Chemo-induced menopause symptoms can start immediately or be delayed, and may be temporary or permanent – with some women experiencing the return of their periods anywhere from several months up to two years following the cessation of chemotherapy – and others who never have a period again.¹³

Radiation

Radiation for treating breast cancer is typically localized to the entire breast that’s affected. This type of treatment doesn’t cause early menopause as a side effect.¹⁴ Treatments like whole body or pelvic radiation therapy, however, which are used to treat other types of cancer, can impact fertility, damage the ovaries and result in early menopause. Like chemotherapy, however, the type of early menopause that follows radiation therapy may be temporary or permanent.¹⁵  

Hormone Therapy

This treatment option is reserved for breast cancer types that are sensitive to hormones. Some therapies work by decreasing the body’s production of hormones, while others block hormones from attaching to certain receptors and cells. Hormone therapy is often used concurrently with certain cancer treatment surgeries to shrink the cancer or reduce the risk of recurrence.¹⁶

Side effects of hormone therapy for breast cancer can include hot flashes, night sweats, vaginal discharge, and irregular periods. Common medications include Tamoxifen, that work to prevent hormones from attaching to cancer receptors and cells and aromatase inhibitors, which reduce the amount of estrogen in the body. Aromatase inhibitors are typically reserved for women who’ve already gone through menopause and can be associated with side effects like joint pain or vaginal irritation.¹⁷

Surgery

Surgical procedures for removing breast cancer include lumpectomies, which remove an individual tumor from the breast and are most often done in early cancer stages, and mastectomies, which remove one or both breasts in their entirety. Additional treatments may be needed following removal surgery, such as chemotherapy or radiation.¹⁸

A risk reducing surgical option for women who may be at a higher risk for breast cancer is known as an oophorectomy, which involves the removal of a woman’s ovaries. An oophorectomy immediately stops the body’s primary production of estrogen, and because of this, menopause onset is immediate and permanent, which can be intense, as symptoms often appear overnight.¹⁹

Lifestyle Changes That May Help Reduce Breast Cancer Risk During and After Menopause

While you can’t change your age or genetics, in addition to getting a mammogram every year starting at age 40,²⁰ you can also consider incorporating certain proactive lifestyle changes into your routine to support your health and wellness, while potentially reducing your risks for breast cancer.

Dietary Considerations

While there is currently only a proposed link between cancer risk and diet, there’s still no harm in incorporating more healthy options into your daily menu. Consider moving toward a diet low in fat and full of fresh fruit and vegetables – and do your best to stay away from processed sugars and red meats.²¹  A fan favorite diet during menopause is the Mediterranean diet, which not only can help with menopause symptoms like inflammation, hot flashes and night sweats, but it may also be helpful for reducing the mortality rate of some cancers, along with reducing risk.²² An increased intake of alcohol may also be considered to be a risk factor for breast cancer due to its impact on estrogen levels. Avoiding or cutting back on alcohol consumption in your diet may help lower your risk.²³

Sleep

Sleep also may play a key role in supporting better health. Getting enough quality sleep may help to lower breast cancer risk. Some studies show that sleep deficiency may increase the risk of breast cancer development, however more research needs to be done to better understand the direct correlation.²⁴

Exercise and Weight Management

According to research, women who exercise routinely have a 10%-20% lower risk for breast cancer than those who aren’t active.²⁵  Exercise and moving your body daily has numerous benefits, including supporting your general health and wellness and potentially reducing cancer risk. Additionally, studies have shown that women who are overweight or obese are at a heightened risk for breast cancer compared to those who maintain a healthy weight; overweight women who have already had breast cancer may also be at a greater risk for recurrence.²⁶  Do what you can to support a healthy diet and weight, and remember to stay active, the benefits are worth it!

Doing things to prioritize your health and wellbeing can be incredibly helpful for reducing breast cancer risk, in addition to providing better support to your body during the menopause transition and beyond.

As discussed, although menopause does not directly cause breast cancer, both age and cancer treatment therapies can play a part in transitioning through menopause early. Ensure you are keeping up with medical appointments and regular checkups, and of course, don’t hesitate to discuss any concerns or breast cancer risk factors with your healthcare provider.

Resources

1. https://www.komen.org/breast-cancer/facts-statistics/research-studies/topics/age-at-menopause-and-breast-cancer-risk/
2. https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/benefits-and-risks-of-hormone-replacement-therapy-hrt/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559995/
4. https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones
5. https://www.komen.org/breast-cancer/facts-statistics/research-studies/topics/age-at-menopause-and-breast-cancer-risk/
6. https://pubmed.ncbi.nlm.nih.gov/10517172/
7. https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/
8. https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/
9. https://medlineplus.gov/ency/patientinstructions/000912.htm
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3695534/
11. https://www.nationalbreastcancer.org/breast-cancer-treatment/
12. https://www.breastcancer.org/treatment-side-effects/menopause
13. https://www.healthline.com/health/cancer/how-long-does-chemo-induced-menopause-last#symptom-management
14. https://www.cancer.org/cancer/types/breast-cancer/treatment/radiation-for-breast-cancer.html
15. https://www.askearlymenopause.org/articles/early-menopause-due-to-chemotherapy-radiotherapy/
16. https://www.mayoclinic.org/tests-procedures/hormone-therapy-for-breast-cancer/about/pac-20384943
17. https://www.mayoclinic.org/tests-procedures/hormone-therapy-for-breast-cancer/about/pac-20384943
18. https://my.clevelandclinic.org/health/treatments/8338-breast-cancer-surgery
19. https://www.mayoclinic.org/tests-procedures/hormone-therapy-for-breast-cancer/about/pac-20384943
20. https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
21. https://www.cancer.org/cancer/types/breast-cancer/risk-and-prevention/can-i-lower-my-risk.html
22. https://www.nfcr.org/blog/does-the-mediterranean-diet-prevent-cancer
23. https://www.cancer.org/cancer/risk-prevention/diet-physical-activity/alcohol-use-and-cancer.html
24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519507/
25. https://www.komen.org/breast-cancer/risk-factor/lack-of-exercise
26. https://www.breastcancer.org/risk/risk-factors/being-overweight