EMW07 (Eden)

Name: Eden
Age at interview: 39
Diagnosis: Menopausal symptoms as a result of hormone (adjuvant endocrine) therapy
Age at diagnosis: 35

Background: Eden works full-time in the higher education sector. She lives with her partner and their child in a metropolitan city. Eden identifies as British.

About Eden: After the discovery of a cancerous lump in her breast at age 35, Eden had a mastectomy, followed by chemotherapy, radiotherapy, and hormone (adjuvant endocrine) therapy as her cancer was hormone sensitive. Eden started experiencing menopausal symptoms after beginning adjuvant endocrine therapy (initially tamoxifen, then goserelin and exemestane). She is unsure what will happen to her menstrual cycle once she finishes endocrine therapy.

More about Eden: A year after migrating to Australia from the UK with her partner and young daughter, Eden, then 35, found a lump in her breast. Further tests indicated the lump was cancerous, and she had a mastectomy, radiotherapy and chemotherapy.

As Eden’s cancer was hormone positive, she was prescribed adjuvant endocrine therapy to reduce her oestrogen production. Initially she took tamoxifen tablets, and then changed to monthly goserelin injections and exemestane, which she has been prescribed for at least five years. Although her period stopped after she received her cancer diagnosis, Eden only began experiencing menopausal symptoms after starting tamoxifen.

Eden described being told before commencing chemotherapy that the treatment might compromise her fertility. She declined an offer to have some eggs frozen, as she and her partner did not want to have another child. Despite understanding that cancer treatment would affect her fertility, Eden said she did not realise that this would ‘mean’ experiencing menopause, and did not recall the word menopause being mentioned until she began taking goserelin and exemestane. She said she had not been given clear information about what would happen to her menstrual cycle after endocrine therapy ended.

Hot flushes and lowered libido have been the main menopausal symptoms Eden has experienced. She described hot flushes as ‘tedious’ but has dealt with them by wearing layers and cooler fabrics, and drinking plenty of water. Eden said her loss of libido was ‘not a problem’ for her, but had caused some difficulties in her relationship with her partner. She is aware that bone and cardiovascular health can be negatively affected by early menopause. To prevent this she takes a vitamin D supplement and maintains a high level of fitness, running up to 10km on a regular basis. Eden’s DXA scans until now have shown no loss of bone density.

Apart from her ‘absolutely wonderful’ surgeon, Eden said she had found allied health professionals to be better at holistic, person-centred care than medical specialists. Eden consulted an oncology-based counsellor for several months while undergoing cancer treatment, but said she had had little interest in attending a support group. For Eden, early menopause has been ‘peripheral’ in comparison to ‘intensely scary’ breast cancer. Of experiencing cancer and menopause, Eden said ‘it’s not what anyone would plan,’ but she has appreciated the support she and her family have received, and has attempted to ‘take it in stride.’