Elephants And Tea - March 2021 - 34

Sexuality

INTIMATE ISSUES WITH MARLOE

WHY AM I SUDDENLY
EXPERIENCING THESE
SYMPTOMS?
During the natural menopause transition,
hot flashes are a sign of decreasing levels of
estrogen. But for young survivors, a menopausal hormonal state (read: low estrogen
levels) can be artificially induced by cancer
treatments. Most of our estrogen is made
by our ovaries, and this estrogen production can slow or stop in response to certain
types of chemotherapy or radiation, or if
both ovaries are surgically removed. Also,
endocrine treatments (such as tamoxifen,
aromatase inhibitors, and ovarian suppression) either reduce the amount of circulating estrogen or disrupt its effects.
No matter which treatment is the culprit, the impact is the same - menopausal
symptoms, including hot flashes. And unlike the gradual decline of hormone levels
during natural menopause, the sudden
and drastic drop in estrogen from these
treatments can mean worse symptoms3,5.
WHAT DOES ESTROGEN HAVE
TO DO WITH HOW HOT I'M
FEELING?
Honestly, the exact mechanism of hot
f lashes is still somewhat unknown 6.
However, we do know that estrogen
impacts the hypothalamus, a part of the
brain responsible for temperature regulation6. Fluctuating levels of estrogen seem to
confuse this regulation process, with lower
levels narrowing the tolerance our bodies
have for temperature changes. This causes
an exaggerated cooling response to occur
even with only small increases in body
temperature7. Blood flow and vasodilation
(expansion of small blood vessels) leads to
visibly flushed skin and an increase in skin
temperature3, which can be accompanied
by sweating.
The sensation often starts in the chest
and neck and radiates out. Some people
also report a racing heart or palpitations,
as well as transient feelings of anxiety or
uneasiness 6,7. Episodes can last several
minutes, and may be followed by an immediate sensation of feeling cold or chilled.
This makes sense, because these physiological changes really do successfully
decrease your core body temperature3,7!

34

ELEPHANTSANDTEA.COM
MARCH 2021

I'M SO MISERABLE! WHAT CAN I DO?
Depending on their severity and frequency, hot flashes and night sweats can really impact your quality of
life. The suddenness and unpredictability of episodes can lead to embarrassment and discomfort. They
may disrupt your sleep and contribute to daytime fatigue, which can have a snowball effect on your energy
level, mood, and even your libido. Your relationship might be affected, if the warmth from cuddling and
touch is a trigger. Not to mention that it's hard to feel sexy when you're experiencing a symptom associated
with a life change that isn't supposed to happen for another couple of decades (although, plenty of women
are sporting their sexy selves after menopause, trust me!).
Management options can be distilled into a few different categories: behavioral and lifestyle modifications, prescription treatments, and complementary and alternative therapies. Some interventions
are better supported by evidence than others. Most available studies have looked at women without
cancer who are going through natural menopause, and there is less known about how to manage
hot flashes in cancer and AYA populations.
Guidelines are available from several trusted organizations2,5,8, but there is still not complete agreement among experts on which interventions are considered appropriate and worthwhile options for
survivors. This makes it extra important that you talk with your provider about what is right for you.



Elephants And Tea - March 2021

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