Supporting Students Facing Medical Menopause After Cancer
It is estimated that around 30% of women who have cancer treatment will experience medical menopause. Cancer treatments such as surgery and chemotherapy can trigger sudden, medically-induced menopause and fertility loss often with intense physical, emotional, and psychological effects.
Often patients are not forewarned that this will happen meaning they are then not able seek help for their symptoms, or are very scared by them, because they do not know that what they are experiencing is menopause. They may instead mistake their symptoms as other side effects, or being caused by their cancer or a separate health issue – quite often a mental health issue.
Even for women who do understand what is happening to them, they are often left with no medical support for their symptoms. Many are told that HRT is not an option because of the risks of ‘feeding’ the cancer and they reach a dead end being told that nothing else is available. They are expected to be grateful they are alive and simply get on with life.
There is much wrong with this picture:
Informed Consent – I feel passionate that patients are fully informed of all the risks and consequences of their treatment. It gives the opportunity for discussions to be had and preparations to be made before irreversible changes occur. This is especially pertinent when loss of fertility is likely. It is not always the case but sometimes some fertility treatment is possible. Additionally, it is not only an ethical imperative, but also trauma informed to advise women of what is likely to happen so they are not shocked and frightened when they come out of surgery and straight into raging hot flushes (as happened with one lady I worked with).
Holistic Integrated Care is Essential – having attended the IPM Congress last June I was heartened to hear from researchers and specialists that in their view the best outcomes for cancer treatment happen when there is holistic care and patient involvement in decision making. This means taking the whole person into account when thinking about treatment, side effects and quality of life; offering more than drugs and surgery to improve wellbeing, and involving the patient in choosing the best course of treatment.
Menopause Support is Possible – It is not true that HRT is automatically ruled out for any woman with cancer. There are times when it is safe to take and, even when oral HRT is ruled out, vaginal oestrogen can still be safely prescribed for many women who need it. Non-hormonal medical interventions are also very useful and effective and avoid the risk for hormone sensitive cancers. For example, some women find SSRI/SNRI can be helpful with unmanageable hot flushes. It is important that women are referred to a menopause specialist who can navigate the many symptoms and solutions available.
How Yoga Teachers Can Help:
While medical menopause can have devastating consequences such as the loss of fertility and life changing symptoms, all is not lost. We cannot of course cure or reverse the process through yoga but there is much we can offer that is of great value to our students.
First and foremost we can ask our students whether or not they are experiencing medical menopause and what symptoms they are struggling with. If we don’t know then we can’t help!
So often menopause is not a subject of conversation in their oncology appointments and women are used to suffering in silence. Simply acknowledging that this is part of cancer too, that their symptoms are worth talking about, that their feelings are valid and we will take their needs into account can be very powerful. Just being seen and heard has therapeutic value.
Second we can make our classes menopause friendly. This can be on many levels:
Make menopause is part of the conversation, that students know they can talk about it as part of their cancer – for example when you have a check-in at the start of class. I have seen the shock and relief on women’s faces when I directly ask about menopause and they realise they’re allowed to say how they feel and ask for help.
Take practical steps to ensure your students are comfortable in class such as allowing drinks in class, checking how everyone is feeling regarding temperature and offering soft props to sit on. If you already teach menopause classes then much of what you do there would be helpful.
Include menopause symptoms as part of the picture when we are lesson planning, adding in useful practises to help with specific symptoms, such as a cooling breath, or explaining how certain practises are useful in multiple ways including some menopause symptoms. E.g. simple joint mobilising can be useful for when people are fatigued to increase prana, but also are useful for menopausal joint aches.
Empower your students to advocate for their needs and seek more medical help if they need it. Not only can we offer moral support and signposting, through their yoga practise students can gain more confidence in their abilities and learn stress management techniques that can help them face asking for more help.
Since women's health is a great passion of mine and because most of our students are women, I have included a whole specialist module on Medical or 'Crash' Menopause in my accredited 12 week YFCA Holistic Teacher Training Course. It is something that many women live with yet few are trained to fully understand or support.
If you would like to offer effective, whole person and trauma informed support to your students dealing with medical menopause I would love for you to join us on the next cohort.
You can find out more and book a discovery call here.