The link between breast cancer and menopause: what yoga teachers need to know

It is October as I write this which it both breast cancer awareness month and menopause awareness month. I’m really happy that both of these important women’s health issues have much more public awareness around them these days. What is often overlooked though is how often these are not always two separate issues and that breast cancer can quite often lead to an early menopause.

As yoga teachers we are likely to be supporting women who are going through or recovering from breast cancer treatment as it is the most common cancer to affect women and, for the most part it’s women who make up the vast majority of the student body. We may well be focused, and rightly so, on recovery form breast surgery, improving range of movement and strength, as well as giving yoga tools to help with stress and anxiety. However, what is often unspoken by students are the menopausal symptoms they may be experiencing as a result of their treatment.

Cancer Induced Menopause is Often Silent

I would be natural to imagine that menopause and fertility issues would mainly or only occur with gynaecological cancers. It is not an immediately obvious link to think about those issues in connection to breast cancer. However, both chemotherapy as primary treatment, and hormone therapy (such as tamoxifen) to prevent recurrence in hormone sensitive breast cancers, can and do cause medical menopause. Sometimes this can be temporary and sometimes this is permanent. We cannot know in advance if cycles and fertility will return once treatment is ended.

Currently there is little medical support for these women who can be thrust into an early menopause with none of the gradual transition that can happen when it is a natural process. Not only are they put out of their natural timeline, often it means symptoms are more intense and harder to manage. For some there is additional heartbreak of loss of fertility.

It is common for these breast cancer patients to be told that HRT is not an option as it can be a risk factor for their cancer recurring and often they are left with little or no support to cope with their symptoms alone. Added to this can be a sense of guilt about complaining about their symptoms after receiving so much medical support already and this can be compounded by messages that they should just be grateful to be alive.

Ask your students about medical menopause

This belief that there is nothing that can be don’t and that they should not complain, means that many students do not mention that they are experiencing medical menopause on their health questionnaire or in consultation. It may not have been something that immediately comes to your mind either, especially if they are in their 20’s or 30’s.

I recommend that if you have a female student undergoing cancer treatment that you specifically ask about her menstrual health and any menopausal symptoms. In my experience they are grateful to be asked, and for those symptoms and emotions to be recognised and honoured as something worth seeking help for. Time and again I have seen the look of surprise and relief when they realise their yoga class is place where they are allowed to talk about their experience and get some useful support.

How yoga can help with menopause issues

Of course, as yoga teachers we cannot magically fix their menopause and fertility issues, but we do have wealth of practises at our disposal to help manage symptoms and offer emotional support.

First of all, simply being heard and taken seriously has huge value. Instead of being told they just need to suck it up and get used to it, receiving empathy an understanding is a game changer which can have positive knock-on effects in confidence and self-esteem.

By sensitively raising these issues in class, we take the shame and embarrassment that some women may be feeling and enable some peer support to occur in the group. Women often share their experiences with each other in my classes which breaks the feeling of being alone with their problems. Some are also able to give suggestions based on what they have found useful.

We can offer holistic support through specific yoga practises to help them with their physical symptoms such as aching joints, hot flushes, pelvic floor issues and poor sleep. We can offer really nurturing restorative practises for exhaustion and to find comfort in their body. Breath work and meditation can be wonderful for emotional release and mental focus. All of these together can have  a quite profound effect on someone’s overall quality of life which shouldn’t be underestimated.

It's one of the many reasons I am so passionate about this work and the support we can offer as yoga teachers to change the lives of women with cancer in our communities. It is also why I have included two specialist modules on women’s health within the full Yoga for Cancer Holistic Teacher Training Course – one on recovering from breast surgery and the other to address the needs of women with medical menopause.

If you would like to take the step to be a specialist yoga for cancer teacher you can find the full curriculum and course information here.