Ask your healthcare provider about specific side effects you can expect from your specific chemotherapy medicines. Also, discuss with your provider any side effects that are troubling you, or that you feel unable to manage.

How Will Chemotherapy Affect My Menstrual Cycle?

Cancer and its treatment will undoubtedly cause many changes in your life. One change you may experience from chemotherapy is alterations in your menstrual cycles - from irregular periods to the symptoms of menopause (the end of menstruation).

Experts don't fully understand all of chemotherapy's effects on the female reproductive system, but this article will begin to answer some of the questions you may have, including:

• How does chemotherapy cause or contribute to the development of menopause?
• Will chemotherapy affect my ability to get pregnant?
• What are the symptoms of menopause and how can I deal with them?
• How will I know if the way I am feeling is associated with menopause and not with my treatment, stress, or another factor?
• What are some other conditions related to menopause?

What Is Menopause?

Menopause is a normal stage in a woman's life. The term menopause is commonly used to describe any of the changes a woman experiences either before or after she stops menstruating. As menopause nears, the ovaries produce less estrogen, causing changes in the menstrual cycle and other physical changes.

Technically, menopause is the end of the reproductive phase of a woman's life, when the ovaries no longer produce eggs and she has her last menstrual cycle. The diagnosis of menopause is not confirmed until a woman has not had her period for six consecutive months.

How Does Chemotherapy Influence The Onset Of Menopause?

During chemotherapy, women may have irregular menstrual cycles or amenorrhea (disappearance of menstrual periods). Some medications used in chemotherapy may also cause damage to the ovaries, resulting in menopausal symptoms or menopause.

Menopause triggered by chemotherapy may be immediate or delayed, permanent or temporary. Unfortunately, there is no way to accurately determine how or when chemotherapy or other cancer treatments will affect your menstrual cycle.

However, menopause is rarely a sudden response to chemotherapy. When treatments begin, you may notice some menopausal symptoms, but usually the symptoms are delayed for several months after treatment is started. This is natural. Menopausal symptoms may last for years after treatment is completed.

The most common symptoms of menopause are hot flashes, emotional changes, changes in the vagina, sexuality changes, and weight gain.

Will My Menstrual Flow Be Different After Chemotherapy?

Menstrual cycles vary from woman to woman. Some women may experience less frequent cycles than they had prior to chemotherapy. They may skip a period or increase the number of days between periods. Other women may have more frequent periods.

Some women may not experience a change in the length of their menstrual cycles but the flow pattern may be different than it was before treatment (the number of days or amount of flow may diminish or the flow may be heavier). Mixed patterns are also common: some women may have shorter menstrual cycles with heavier bleeding, or infrequent cycles with many days of a very high flow.

In cancer treatment, chemotherapy refers to the use of drugs to kill or slow the growth of rapidly multiplying cells.

Chemotherapy usually includes a combination of drugs, since this is more effective than a single drug given alone. There are many drug combinations used to treat breast cancer. Ask your doctor for specific information and side effects you can expect from your chemotherapy medications.

How Is Chemotherapy Given?

Chemotherapy drugs are given intravenously (directly into a vein) or orally (by mouth). Once the drugs enter the bloodstream, they travel to all parts of the body in order to reach cancer cells that may have spread beyond the breast -- therefore chemotherapy is considered a "systemic" form of breast cancer treatment.

Chemotherapy is given in cycles of treatment followed by a recovery period. The entire chemotherapy treatment generally lasts three to six months, depending on the type of drugs given.

When Is Chemotherapy Given?

When breast cancer is limited to the breast or lymph nodes, chemotherapy may be given after a lumpectomy or mastectomy. This is known as adjuvant treatment and may help reduce the chance of breast cancer recurrence.

Chemotherapy is sometimes given before surgery (called neoadjuvant treatment) in order to shrink the tumor so it can be removed more easily or so that a lumpectomy can be performed instead of a mastectomy.

Chemotherapy may also be given as the main treatment for women whose cancer has spread to other parts of the body outside of the breast and lymph nodes. This spread is known as metastatic breast cancer and occurs in a small number of women at the time of diagnosis, or when the cancer recurs some time after initial treatment for localized (non-metastatic) breast cancer.

Can I Still Work While Receiving Chemotherapy Treatments?

Yes. Most people are able to continue working while they are being treated with chemotherapy. It may be possible to schedule your treatments later in the day or right before the weekend so they don't interfere as much with your work schedule. You may have to adjust your work schedule while receiving chemotherapy, especially if you have side effects.

How Will I Know If The Chemotherapy Treatments Are Working?

Some people may think that their chemotherapy treatment is not working if they do not experience side effects. This is just a myth.

If you are receiving adjuvant chemotherapy (after surgery that removed all of the known cancer), it is not possible for your doctor to directly determine whether the treatment is working because there are no tumors left to assess. However, adjuvant chemotherapy treatments have proved helpful in studies in which some women were given chemotherapy while others were not.

After completing adjuvant therapy, your doctor will evaluate your progress through periodic physical examinations, routine mammography, and appropriate testing if a new problem develops. If you are receiving chemotherapy for metastatic disease, progress will be monitored by blood tests, scans, and/or X-rays.

What Are The Potential Side Effects Of Chemotherapy Drugs?

The specific side effects you will experience depend on the type and amount of medications you are given and how long you will be taking them. The most common temporary side effects include:

• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Changes in menstrual cycle
• Higher risk of infection (due to decreased white blood cells)
• Bruising or bleeding
• Fatigue