Early menopause

A hot flash is a sudden increase in body heat, often with sweating. You usually feel hot flashes in your face, neck, and chest. Here are some tips for managing hot flashes:

• Dress in layers you can easily remove to stay cool.
• Avoid common hot-flash triggers such as hot drinks, smoking, spicy food, caffeine, and alcohol. Find your triggers by noting what you ate or did shortly before a hot flash.
• If you're feeling stressed, try Mindfulness-Based Stress Reduction (MBSR) or other complementary therapies. For example, acupuncture can be helpful in improving hot-flash severity and sleep.
• Some lifestyle changes can improve hot flashes. These include:
  • Dressing in layers
  • Increasing regular exercise
  • Eliminating foods and drinks that trigger hot flashes
  • Sleeping in a cool room in wicking pajamas (wicking fabrics pull sweat away from skin)
  • Stopping smoking if you smoke
  • Starting a regular mindfulness practice to reduce stress
• Certain nerve pain medicines, anti-anxiety medicines, and antidepressants have been shown to decrease hot flashes and night sweats. These medicines may be helpful for you if symptoms are very bothersome. Talk with your care team about options if hot flashes are interfering with your daily life.
• Know that hot flashes resolve over time. Still, over 10% of women will have hot flashes for more than 10 years. That's why it's important to talk with your care team about ways to get relief.

Night sweats are periods of intense sweating while sleeping. They can soak your pajamas and sheets and cause you to wake up. Here are some ways to stay comfortable:

• Keep your bedroom cool.
• Avoid heavy comforters or flannel sheets. Sleep with layers of covers that can be removed.
• Wear lightweight sleepwear, or nothing.
• The medicines used to help with hot flashes can usually help with night sweats, too.
• Know that night sweats usually resolve over time.

Vaginal dryness is dry, irritated, thinning vaginal tissue caused by decreased estrogen levels that happen with early menopause. Try these tips for managing vaginal dryness:

• Use non-hormonal vaginal moisturizers such as Revaree, Replens, or Me Again. Oil from vitamin E capsules may also help. Be careful to avoid products with alcohol or perfumes. These can be irritating.
• If vaginal moisturizers without hormones aren't working well for you, talk with your care team about low-dose vaginal estrogen. 2025 research published in the American Journal of Obstetrics and Gynecology shows that low-dose vaginal estrogen—which includes creams, rings, and vaginal tablets—is generally regarded as safe in people with a history of breast cancer when used in discussion with your medical oncologist. Always talk with your doctor about your individual risk and whether vaginal estrogen may be right for you. Learn more on the Menopausal symptoms page.
• Before having penetrative sex, use a sexual lubricant such as Astroglide, KY, or Good Clean Love. Do not use lubricants advertised as warming or arousing. They can be irritating.

Sometimes, having one painful sexual experience can cause you to unintentionally tighten the pelvic floor muscles when you attempt sex again. Tightening these muscles can make penetration more uncomfortable.

If you think this is happening to you, ask about physical therapy focusing on pelvic floor dysfunction. A trained therapist can help you learn how to relax those muscles and improve comfort during sex.

If sex has been painful because of vaginal dryness, you may have less sexual desire. Try these tips:

• Use non-hormonal vaginal moisturizers to help with vaginal dryness.
• If non-hormonal moisturizers are not helping, ask your care team if vaginal estrogen may be an option. Learn more about vaginal estrogen on the Menopausal symptoms page.
• If sex is painful, spend time enjoying your body (and your partner’s, if you have a partner) in whatever way is comfortable for you.
• Apply sexual lubricant generously on yourself, a partner, or a sex toy before penetration or other sexual activity.
• If you’ve had difficulty with sexual activity, you may need to rebuild positive sexual experiences before your libido returns. You’re not alone, and this is a normal reaction to the effects of some breast cancer treatments. Be kind to yourself and take your time exploring what works for you.

Some antidepressants may reduce sexual desire. Ask your care team about good options less likely to cause this effect.

Talk with your care team or an oncology social worker about other ways to improve desire. You can also ask for a referral to see a sexual health specialist with experience helping people who’ve been diagnosed with cancer.

Learn more in Sex and intimacy.

Early menopause can cause an increase in bone cell breakdown. This means bones can be more likely to fracture. To keep your bones strong, try these strategies:   

• Eat calcium-rich foods, such as kale, shellfish, and dairy.
• Walk or run regularly. Consider adding a weighted vest, which has pockets that hold small weights. Weight-bearing exercise strengthens bones.
• Ask your care team about whether calcium and vitamin D supplements are appropriate for you and if you should have a bone density DEXA scan test.
• There are also medicines available to help strengthen bones if lifestyle changes are not enough. Talk with your team about what’s best for your individual situation. 

Learn more about bone loss and things you can do. Visit the Bone loss page. 

You can find more strategies for managing symptoms on the Menopausal symptoms page.