Imagine suffering through the hot flashes, mood swings, and brain fog that typically accompany menopause; then imagine having to do it all over again, years later.
Australian pop star Kylie Minogue, 49, says she’s preparing for her second round of menopause, after first experiencing the loss of menstruation during treatment for breast cancer 12 years ago.
“I’ve already done it once,” she told the Daily Mail in an interview published over the weekend. “The first was medically induced when they suppressed my [estrogen] for my cancer treatment. So at least I know what it will be like. I’m ahead of the game with that experience.”
Double menopause sounds shocking, but experts say Minogue isn’t the only one to go through two sets of changes. Indeed, younger premenopausal breast cancer patients often undergo what’s called ovarian suppression, in which the ovaries are targeted with a medication that stops them from producing estrogen, in order to halt tumor growth. Ovarian suppression typically ushers in the same symptoms as menopause: hot flashes, dry skin, mental fatigue, and more. But once treatment is complete, some patients’ ovaries will begin to produce estrogen again, reversing the early-onset menopause — and setting the stage for what feels like a second menopause around the age of 50.
“Fifty to 60 percent of patients diagnosed while premenopausal have complete ovarian suppression, which means they have no return of ovarian function,” Dr. Roshni Rao, chief of breast surgery at New York-Presbyterian/Columbia University, tells Yahoo Lifestyle. The other 40 to 50 percent — including Minogue — will experience a return of function, and then a second, natural period of menopause. That’s good news for patients hoping to have children after treatment, but bad news for those hoping to have gotten menopause out of the way.
Luckily, Rao says that a natural menopause is typically less intense than the first, medically induced experience, which can happen almost instantly. “You can imagine, if you go through [menopause] quickly, it’s going to be harder on you than a more natural progression over a few years,” says Rao. Plus, she says, breast cancer survivors “might be in a better position to understand what the side effects are.”
Treating those side effects requires a little more finesse than a typical scenario. Hormone replacement therapy, which is commonly used to treat difficult cases of menopause, is not an option for those who are undergoing or have undergone breast cancer treatment. “That doesn’t mean we don’t do anything,” says Rao. “If you have hot flashes, we can put you on medication that helps with hot flashes. We do have different ways.”
She urges anyone undergoing menopause — cancer patient or not — to speak with a doctor about treatment options. “As women, we tend to have this need to [tough it out],” she says. “The main thing to know is that there are options to help you.”
Minogue has her own nuanced treatment plan. She says that while her first experience left her “flummoxed” and “hot,” she’s going into her second round with a strategy in place. “I remember a friend of mine a bit older than me used to open the fridge and stand in front of it,” she says. When hot flashes hit again, she says, “I’ll be back in the fridge!”
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