amenorrhea – Bri D. PT.

How it’s going…

You may remember me posting a while back about the different ways I tried to protect my fertility as I prepared to start chemotherapy. First, I froze some eggs. In case I’m unable to conceive naturally later, I can use them for IVF. I also started monthly Zoladex injections – a medication that halts ovarian function in an attempt to preserve fertility overall.

And so, at age 31, I’ve been in a Zoladex-induced menopause since June. Six whole months later, my estrogen levels have tanked and my joints ache like I’m an 100-year-old lady! Some other fun side effects include amenorrhea (lack of a period), hot flashes, and dyspareunia. So, I’m currently staying as active as possible (mostly walking and stretching when I have the energy) in order to mitigate some of those side effects, and thankfully, my oncologist and I decided it was time to discontinue the Zoladex now that the bulk of treatment is behind me. Today marks one month since my last injection!

For more detailed info about fertility preservation, you can read my earlier post here.

What to expect now?

Typically, the menstrual cycle can take a few months to return as the body figures out its new normal once again. As I have some previous experience with amenorrhea after I came off the birth control pill in 2019, I know that what I eat will play a huge role in how quickly my body gets back to normal. Thus, the plant-based diet continues (plus no dairy, processed sugars, or alcohol) and I will try my absolute hardest to cut back on caffeine to keep my nervous system calm.

I also plan to use seed cycling to help my body regulate the essential hormones it needs for menstruation and ovulation. This is a great article about how to do seed cycling if you’re interested in learning more. Seed cycling is an excellent, natural way to balance hormones, however if you have hormone-positive cancer, please ask your doctor if a daily dose of phytoestrogens is safe for you!

Once I’ve completed radiation therapy, I’ll speak with my medical oncologist and OB/GYN about when it will be safe to start trying to conceive. With that said, I think my body deserves a long break to heal completely before that all happens. Actually, this might be a good time to kindly remind you that it’s just not acceptable to ask a person when they plan to have children. A person’s body is their own to make decisions for and, sometimes, people aren’t capable or willing to have children at all.

My goal for this blog has always been to be as open and honest about my experiences as possible in the hopes that whoever may be reading this can gain some insight for their own health and wellness. Personally, I don’t think there’s ever TMI (too much information) disclosed when it comes to learning about your own body and how it works. This coming from a pelvic floor PT who talks about poop all day… Anyway, I’d love to know what questions you have about:

fertility preservation during cancer treatments
long-term side effects of the birth control pill
nutrition around hormone balance
seed cycling

Drop your Q’s in the comments below!

On today’s blog, I wanted to bring attention to female pelvic pain and dyspareunia (pain with intercourse) secondary to cancer treatments.

Often, when a woman has gone through adjuvant hormonal treatments, chemotherapy, abdominal/pelvic radiation, or fertility-saving drugs during active treatment, the body goes into a state of menopause or “chemopause” as it’s commonly referred to in the cancer world.

Low estrogen levels during chemopause can cause symptoms like:

Amenorrhea (loss of menstrual cycle)
Low libido
Vaginal dryness or atrophy
Hot flashes
Mood changes
Joint aches and pains

In particular, vaginal dryness or atrophy can have a huge impact on sexual health, emotional health, and relationships post-cancer. If the pelvic floor muscles are compromised by treatment, it can result in pelvic pain (like pain from overactive or tight pelvic floor muscles, pain in the tailbone, lower abdominal pain, or pain around post-surgical scars), bladder/bowel changes, or painful sex.

Thankfully, a pelvic floor physical therapist with specialized training in examination and treatment of the pelvic floor muscles can treat these conditions and are an amazing asset to oncology patients on their road to recovery. Some PT treatments for pelvic pain and dyspareunia may involve:

Pelvic floor muscle strengthening or relaxation exercises with or without biofeedback training (computer or ultrasound-based pelvic floor training technology)
Stretches for tight muscles around the abdomen, pelvis or hips
Manual therapy including general massage, pelvic floor muscle release techniques, or scar tissue mobilization
Education and lifestyle strategies surrounding posture, nutrition, bowel and bladder habits, and lubrication options during intercourse
Education in the use of vaginal dilators to reduce pain that occurs with tampon insertion, gynecological exams, or sex
Encouragement around body image and sexual health (this could include referral to a sex therapist or psychologist when appropriate)

If you’re reading this, and you feel like you could benefit from pelvic floor physical therapy during or after cancer treatment, you can find a qualified pelvic floor PT in your area here or here. Ask your doctor for a referral today!

And a quick reminder for all of us…
The path to recovery from cancer involves a whole host of treatments including chemo, hormonal treatments, surgery, and radiation just to name a few. Each of these treatments can come with significant side effects or long-lasting comorbidities. Just because someone is “cured” from cancer doesn’t always mean they are living without long-term effects from treatment. Keep this in mind, and be kind!

*This blog is part 2 of Pink October’s Pelvic Floor Series, a way to raise awareness of pelvic floor problems during cancer treatment and discuss sex & intimacy after a cancer diagnosis.

Aloha ❤

Bri D. PT.

Pelvic Health PT & Breast Cancer Thriver

Tag: amenorrhea