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Managing Hormonal Side Effects

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Menopause happens naturally with age when a woman’s ovaries make less estrogen. Some chemotherapy treatments can damage a woman’s ovaries causing symptoms of menopause to occur. Symptoms of menopause may continue even after chemotherapy treatment is completed.

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MANAGING HORMONAL SIDE EFFECTS/MENOPAUSAL SYMPTOMS ORAL CHEMOTHERAPY EDUCATION Menopause happens naturally with age when a woman’s ovaries make less estrogen. Some chemotherapy treatments can damage a woman’s ovaries causing symptoms of menopause to occur. Symptoms of menopause may continue even after chemotherapy treatment is completed. Some types of breast cancer are affected by the hormones estrogen and progesterone. Treatments that stop these hormones from helping breast cancer cells grow are called “hormone therapy” or “endocrine therapy.” Side effects of hormone therapy can be like the symptoms of menopause, which are caused by low levels of estrogen. Possible Side Effect Management Hot flashes (sudden sweating and feelings of warmth) Things you can do to make hot flashes less bothersome include: • Wear loose fitting clothing, dress in layers. • Stay hydrated with cool liquids. • Avoid alcohol, caffeine and foods that are hot or spicy. • Sleep in a cool room on cotton sheets. • Participate in mild, regular exercise. • Carry a portable fan. • Keep a personal hot flash diary to record the number, how often, how severe, and the timing of hot flashes so you can identify and avoid the personal triggers that cause your hot flashes. • Inform your care provider if your hot flashes are bothersome as there may be medications that can help. Vaginal dryness Vaginal moisturizers are used on a regular basis to maintain vaginal moisture and health of tissue. They can be used any time and several times a week for overall vaginal health and comfort. Natural oil moisturizers may be applied with the fingertip to the outside or inside vaginal area. • Coconut oil • Olive oil • Vitamin E—comes as a suppository, oil, or capsule. To use the capsule, break it open and apply the oil to the vagina with your fingertip. Commercial moisturizers can be found in the feminine hygiene section of your drug store. Most are inserted into the vagina using an applicator. • Replens™ • Hyalo Gyn® • Luvena® Vaginal lubricants are used during sexual activity to help you feel more comfortable. Natural oil lubricants can be used inside or outside of your vagina. Do not use oil based lubricants if you are using a latex condom. • Vitamin E Water based lubricants can be found at your drug store or online and include brands such as: Astroglide®, KY Jelly®, Aquagel®, Sliquid®, Good Clean Love®, Aloe Cadabra®, Luvena®, Yes® Silicone based lubricants include Pjur®, PINK™, Astroglide® Silicone * Always use a water or silicone based lubricant if you are using a latex condom. * Never use Vaseline as a vaginal lubricant as it can increase the chance and severity of vaginal yeast infections. Vaginal hormones or estrogen creams are available. Discuss with your oncologist to see if this therapy is right for you. Continued on the next page Additional instructions Bone thinning • Include plenty of calcium in your diet. Good sources of calcium include dairy products, almonds, broccoli, kale, canned salmon with bones and sardines. • Include physical activity in your daily routine. Weight bearing activities such as walking, jogging and climbing stairs can help build strong bones and slow bone loss. • Take a Calcium and Vit D supplement as recommended by your doctor. • Do not smoke. • Avoid drinking more than one alcoholic drink per day for women, 2 drinks/day for men. Muscle or joint pain or weakness • Keep a diary of your pain, including a description of when and where the pain is occurring, what it feels like, and how long it lasts. • Stay as active as possible, but know that it is okay to rest as needed, too. • Tell your care provider if pain interferes with your activity. If the pain or weakness bothers you, ask your provider how you may ease this discomfort. • Take only pain medication that has been prescribed or recommended by your care provider. Hair thinning • Avoid hairstyles that pull on hair. • Avoid high heat hair styling tools. • Use a soft brush with natural fibers. • For more information on hair loss refer to the “alopecia” supplemental side effect sheet. Fluid retention • Do not stand for long periods of time. • Keep your legs elevated when sitting or lying down. • Avoid eating salty foods, which can increase swelling. • Avoid wearing tight-fitting clothing and shoes. • Weigh yourself daily. • Contact your care provider if you notice any of the following: o Swelling in the hands, feet, or legs o Shortness of breath o Weight gain of five pounds or more in a week o If you have swelling after you had lymph nodes removed you may experience lymphedema. Notify your doctor. Important notice: The Association of Community Cancer Centers (ACCC), Hematology/Oncology Pharmacy Association (HOPA), National Community Oncology Dispensing Association, Inc. (NCODA), and Oncology Nursing Society (ONS) have collaborated in gathering information for and developing this patient educational supplement. This summarized information represents a brief summary of supportive care information and other resources. This supplement does not cover all existing information related to the possible directions, doses, precautions, interactions, adverse effects, or risks associated with specific medication or adverse events and should not substitute for the advice of a qualified healthcare professional. Provision of this supplement is for informational purposes only and does not constitute or imply endorsement, recommendation, or favoring of this side effect management by ACCC, HOPA, NCODA, or ONS, who assume no liability for and cannot ensure the accuracy of the information presented. The collaborators are not making any representations with respect to the clinical information presented whatsoever, and any and all decisions, with respect to such patient management, are at the sole risk of the individual consuming the medication. All decisions related to education and managing adverse events should be made with the guidance and under the direction of a qualified healthcare professional. Permission: Supplemental Oral Chemotherapy Education (OCE) sheets are provided as a free educational resource for patients with cancer in need of concise, easy-to-understand information about cancer topics and adverse event management. Healthcare providers are permitted to copy and distribute the sheets to patients as well as direct patients to the OCE website for information. However, commercial reproduction or reuse, as well as rebranding or reposting of any type, are strictly prohibited without permission of the copyright holder. Please email permission requests and licensing inquiries to This email address is being protected from spambots. You need JavaScript enabled to view it.. Copyright © 2022. All rights reserved.

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