Questions to ask your healthcare team about menopause after breast cancer

You don’t have to ask every question below. Choose the ones that feel most relevant to you.

Understanding what is happening

• Could my treatment be causing menopause or menopause symptoms?
• Do my symptoms mean I am in menopause?
• Is this change likely to be temporary or permanent?
• Can I still ovulate or become pregnant if my periods have stopped?
• How can we tell whether my symptoms are caused by menopause, treatment, another health issue — or more than one cause?
• Could any of my medicines be making my symptoms worse?
• Which member of my healthcare team should help me manage these symptoms?

Hot flashes and night sweats

• What nonhormonal treatments could help my hot flashes or night sweats?
• Could one of my medicines be making them worse?
• Would keeping a record of my symptoms help us identify patterns or triggers?
• Is elinzanetant (Lynkuet) appropriate for me?
• What can I do if hot flashes are interrupting my sleep or daily activities?
• What are my options if these symptoms are making it difficult to continue treatment?

Sleep: “Why can’t I sleep?”

• Could hot flashes, pain, anxiety, or one of my medicines be disrupting my sleep?
• Could I have a sleep condition that needs to be evaluated?
• Would cognitive behavioral therapy for insomnia, or CBT-I, help me?
• Are any sleep medicines or supplements safe for me to use?
• Could counseling or another form of emotional support help?
• When should I see a sleep specialist?

Fatigue: “Why am I so tired?”

• Is my fatigue different from ordinary tiredness or lack of sleep?
• Could anemia, a thyroid problem, a nutritional deficiency, or another health condition be contributing?
• Could one of my treatments or medicines be causing my fatigue?
• Would changing the timing of my medicine make a difference?
• What type and amount of activity would be safe and helpful for me?
• Should I be referred to a physical therapist, rehabilitation specialist,or registered dietitian?
• What should I do if fatigue is interfering with everyday activities?

Brain fog and changes in thinking

• Could menopause, treatment, or one of my medicines be affecting my memory or concentration?
• Could poor sleep, fatigue, pain, anxiety, or depression be contributing?
• Should any of my medicines or doses be reviewed?
• Would treating another symptom help me think more clearly?
• Would a referral to a speech-language pathologist or neuropsychologist help?
• Are there strategies or rehabilitation programs that could help with memory, focus and organization?
• When do changes in memory or thinking require further evaluation?

Mood and emotional health

• Could menopause, treatment, or one of my medicines be affecting my mood?
• Could poor sleep, pain, or fatigue be making these feelings worse?
• What kinds of emotional-health support are available to me?
• Would counseling, a support group, or medicine help?
• Can you refer me to an oncology social worker, therapist, psychologist, or psychiatrist?
• Could an antidepressant interact with tamoxifen or any of my other medicines?
• Who should I contact if my emotional symptoms become more intense?

Vaginal, vulvar and urinary symptoms

• Could menopause or treatment be causing my dryness, irritation, urinary symptoms, or pain?
• Could there be another cause, such as an infection or pelvic floor problem?
• Which vaginal moisturizers or lubricants would be appropriate for me?
• How often should I use a vaginal moisturizer?
• Could aqueous lidocaine help with pain at the vaginal opening?
• Would pelvic floor physical therapy or vaginal dilators help?
• Are there other nonhormonal treatments I could try?
• If nonhormonal treatments are not enough, could low-dose vaginal estrogen be appropriate for me?
• What are the possible benefits and risks based on my diagnosis and current treatment?
• Should I see a gynecologist, menopause specialist, pelvic floor physical therapist, or sexual-health specialist?

Changes in sexual desire

• Since treatment, I have had very little interest in sex. Could my medicines or side effects be contributing?
• Could treating pain, dryness, fatigue, hot flashes, or sleep problems help?
• Could another medicine I take be affecting sexual desire or response?
• What options might help me feel more comfortable or interested in intimacy?
• Can you refer me to a sexual-health specialist or counselor with experience in cancer care?
• Who can help if changes in sexual health are affecting my relationship or emotional well-being?

Joint, muscle, or bone pain

• Is this pain likely to be a treatment side effect, or should we check for another cause?
• Could my hormonal therapy be causing or worsening the pain?
• What kinds of movement or exercise are safe for me?
• Would physical therapy, acupuncture, massage, heat, or cold help?
• What pain-relieving medicines are safe with my treatment?
• Should I have any tests or imaging?
• If the pain is making hormonal therapy difficult to continue, could I try another aromatase inhibitor or treatment?
• How would changing, pausing, or stopping treatment affect its benefits?
• Does my treatment put my bone health at risk?
• Do I need a bone-density test or other bone-health monitoring now?

Fertility and pregnancy

• How might my treatment affect my fertility?
• Do I have time to freeze eggs or embryos before treatment?
• Could ovarian suppression help protect my ovaries during chemotherapy?
• How long will I need to avoid pregnancy?
• Could I safely pause hormonal therapy in the future to try to become pregnant?
• What options might be available if I cannot become pregnant with my own eggs?
• What will fertility care cost, and are financial assistance programs available?
• Can you refer me to a fertility specialist with experience working with people affected by cancer?
• If my periods return, does that mean my fertility has returned?
• What birth control options are safe for me during treatment?
• How would fertility preservation affect when my cancer treatment begins?
• Who can help me understand the emotional, financial, and practical parts of these decisions?

Weight gain

• Could menopause, my cancer treatment, or one of my medicines be contributing to my weight gain?
• Could changes in muscle mass, fatigue, pain, or activity be affecting my weight?
• What types and amounts of physical activity are safe for me?
• Would a referral to a physical therapist or cancer exercise specialist be helpful?
• Could I meet with a registered dietitian who has experience working with people affected by cancer?
• Are there other health conditions that should be considered?