Navigating the hidden struggles and stepping into a stronger, more authentic self.
There are so many side effects from cancer treatments that it is impossible to know what to expect. Every body is different, and everyone reacts differently to each treatment. Because most treatments compromise your immune system, it is anyone’s guess which of the many side effects you might experience. But there is one side effect that every woman going through chemo will experience: chemically induced menopause. Depending on your age, it may be temporary, or it may be permanent.
When I began TCHP chemo, I was told I would be put into early menopause. What I was not told was what that would actually mean; all the physical changes, emotional upheaval, sexual side effects, and the way it would ripple into my daily life, my relationships, and my parenting. And since I was provided no real details of the many symptoms of this hormonal journey, I have found myself completely caught off guard by how much it has dominated my life since my last chemo session at the end of January. If you find yourself in the same boat, never receiving the “manual” on the journey into menopause (starting with perimenopause), this post is for you. Whether your transition was forced by chemo or is natural, consider this the head’s up that your doctor never provided.
Let’s start with the physical side effects. They have been intense. Hot flashes hit suddenly, forcing me to desperately strip off a layer of clothing, only to put it back on as soon as the heat passes because I then get cold. Night sweats have made it hard to stay comfortable in bed, adding to already restless nights. My dropping estrogen also triggers itchy arms from a histamine reaction, usually set off by heat and sweat in the middle of the night, that feels like someone is poking me with needles from the inside. I have experienced sporadic achy joints as well, especially in my knees, hips, and wrists. These symptoms are all happening because estrogen plays a key role in regulating body temperature, supporting healthy sleep, controlling inflammation, and keeping joints and skin comfortable. When estrogen levels drop, especially suddenly with chemo, all of these systems can go haywire. These symptoms are not just inconvenient; they are exhausting. My body is already working overtime to recover from treatment, and menopause adds another layer of constant discomfort.
Even though I was very aware that hormonal transitions can affect mental and emotional health, actually feeling like my personality is changing has been hard to handle. I find myself irritable over little things, snapping at my kids and family, and feeling a hair-trigger rage I don’t recognize in myself. Anxiety creeps in at times and can feel overwhelming. Because I had already experienced some of these symptoms with the onset of perimenopause before cancer treatment, I was not completely unprepared. In my head, I can remind myself that the rage and irritability are hormonal, but in the moment it is still sometimes hard to meet myself with kindness and grace.
What has struck me going through this experience is just how much hormonal balance influences mental health and how hard it is to quantify. Without estrogen and progesterone to buffer my system, emotional regulation feels raw and jagged. It is not just about moods. It seeps into my relationships, the energy I bring into a room, and the patience I have with the people I love. The hardest part is remembering that when I am quick to snap or low on patience, it is my hormones at play. And not the real me.
The sexual side effects of menopause are rarely discussed but can be deeply impactful on both relationships and a woman’s sense of self. Menopause stripped away a part of my life I had taken for granted since becoming an adult. Vaginal dryness makes intimacy painful and often the desire to even try is not there. Sex, which once felt natural and fun, has become associated with discomfort and frustration. It is not just about losing physical pleasure; it is about losing a way to connect with your partner and a way to feel feminine and desirable. And for those of us who have also lost one or both breasts during treatment, losing sexual desire can feel like another aspect of our identity we are forced to grieve.
Hormone replacement therapy (HRT) is sometimes offered as a lifeline, but for women with hormone-positive breast cancer undergoing treatment, it is off the table during treatment (a lot of doctors would say forever, but I disagree. And that is another blog post . . .) Even if HRT was an option, I have learned that hormones alone are not always enough. Without managing stress, nutrition, movement, and foundational health, HRT cannot fully regulate your system. Progesterone, for example, is a precursor to cortisol. If you are highly stressed, your body “steals” that progesterone to make cortisol, leaving you depleted. Your liver also prioritizes detoxing stress hormones, alcohol, and processed foods over supporting hormone balance. Whether your hormones are being produced naturally or you are on HRT, stress and lifestyle factors can hijack your hormones, leaving you irritable, anxious, bloated, and uncomfortable.
Since HRT is not an option for me right now (and even if it was, I would still be implementing a balanced, holistic approach to ensure that my body was supported and working as optimally as possible), I have focused on natural, foundational practices to help ease my symptoms: seed cycling to support hormone balance, meditation and breathwork to regulate my nervous system and lower cortisol, movement and exercise to improve my mood and keep my strength up. And a mostly keto, anti-inflammatory diet rich in vegetables and protein. I have noticed that processed carbs and sugars worsen my hot flashes and night sweats. These practices do not erase the symptoms, but they make them more manageable, giving me a sense of control in an otherwise uncontrollable situation.
What strikes me most is how little information is given about this stage of life, whether induced by chemo or naturally occurring. Doctors may warn you about menopause, but they rarely explain its full impact on your body, mind, relationships, and sense of self. Women deserve better. We deserve honesty, guidance, resources, and a heads up about this transition, not silence. We deserve education about our bodies, our hormones, and the transitions we go through in life multiple times starting in early adolescence.
One thing I have come to realize on this journey is that menopause mirrors puberty in many ways. Just as the hormonal surges of adolescence reshape the body and mind, menopause reshapes them again, only in reverse. Both are times of upheaval that demand patience, both crack us open to new layers of identity. In puberty, we are flooded with hormones and our sense of self is quite suddenly shifted. It is usually awkward and overwhelming as our bodies, moods, and desires change in ways we do not yet understand. In menopause, our hormones recede, and once again our sense of self transforms. But this time, we carry awareness, the wisdom of lived experience, and the ability to choose how to move forward.
If only women were educated about their hormones earlier in life, perhaps we would not feel so lost when arriving on the doorstep of menopause. Maybe this stage would not feel so scary or unknown. Maybe we would feel more empowered to embrace it for the spiritual opportunity that it can be.
Because although the physical and emotional symptoms have been challenging for me, this stage has also brought increased self-awareness and a deeper connection to my intuition. I can no longer accept the status quo of my body or my mind. Instead, I feel called to reevaluate my identity and the way I want to live my life.
And despite all the hardship and the discomfort, I am trying to embrace the spiritual dimension of this shift. Menopause is not just an ending; it’s a transformation. A transition into another season of life and an opportunity to reflect on identity, purpose, and relationships. I ask myself: what truly serves me now? How can I step more fully into my authenticity? Without hormones softening the edges of my thoughts and feelings, I feel everything more sharply. Menopause has stripped me down to the essentials, and in that rawness, I am discovering new questions and different answers about who I want to be and how I want to live.
If you are going through chemo-induced menopause, perimenopause, or menopause on your own timeline, know that you are not alone. The physical, emotional, and sexual side effects are real, AND so is the potential for growth. Menopause is not just a loss. It is an initiation into another way of being, one that asks us to step into our truth with courage and honesty. While there may not be a handbook provided in the doctor’s office, conversations like this can start to fill in the fine print we all deserve.
