Andropause & Menopause

CURE, Summer 2013, Volume 12, Issue 2

Under normal circumstances, hormonal changes occur later in life, but in adolescents and young adults who have cancer, menopause and andropause can occur earlier as a result of treatment.

As they age, all women eventually lose their fertility naturally. Menopause, the physical change that marks the end of a woman's fertility, is characterized by irregular periods as the ovaries stop producing eggs, as well as a reduction in the production of the hormones estrogen and progesterone.

Andropause, a less well-known physical change in aging men, is similarly characterized by a decline in androgen or sex hormone levels. While fertility doesn't necessarily end for men, andropausal men experience reduced sexual drive and function.

Under normal circumstances, these changes occur later in life, but in adolescents and young adults (AYAs) who have cancer, menopause and andropause can occur earlier as a result of treatment. Often premenopausal women will temporarily stop menstruating during or after treatment (something known as chemotherapy-induced amenorrhea), and some will start menstruating again even a few years after treatment or even become pregnant without menstruation. For others, however, the change is more permanent and they undergo premature menopause as a result of chemotherapy, radiation or surgery. The age of the patient and type and dosage of the therapy can all affect treatment-related menopause. Symptoms include hot flashes, vaginal dryness and mood changes. Management strategies to treat symptoms of menopause include receiving hormones in a patch or pill (if the woman’s tumor isn't estrogen-driven) or, if she is unable to take hormones, taking antidepressants or trying exercise and relaxation to help alleviate hot flashes.

Men can also experience premature andropause as a result of treatment, typically from medical or surgical castration for prostate cancer. Symptoms can include sexual dysfunction, osteoporosis and mood changes. Similar to women, men can take antidepressants to help with hot flashes. Calcium and vitamin D supplements can act as preventive measures for osteoporosis. Healthy lifestyle changes, such as exercise and diet modifications, can also mitigate symptoms.