The first thing I noticed was the joint pain. I was 10 days into my prescribed 10-year hormone treatment regimen and, although I was in my 30s, I had the mobility of an octogenarian. My hip bones were creaky AF, and the cartilage in my knees felt like it was degenerating by the day. It got so bad that I started checking Etsy and Amazon to see whether they sold walking canes—of the fancy, possibly bedazzled variety—or one of those rolling walkers my grandmother had relied on in her final years. (Both do, if you’re curious). 

Sadly, the side effects didn’t stop there. Over the weeks, months, and years that followed, I’ve endured, to varying degrees, a comically long list of menopausal symptoms related to my breast cancer treatment. They include, in no particular order: 

• Brain fog/memory loss
• Fatigue/low energy
• Frozen shoulder
• Cognitive decline, trouble speaking
• Mouth ulcers
• Vaginal dryness/atrophy
• Mood changes: irritability, anxiety
• Joint pain/osteopenia
• Hair loss
• Skin changes
• Itchy ears
• Weight gain
• Eye changes: astigmatism/blurred vision/floaters/dry eyes
• Tinnitus
• Irregular periods
• Vaginal discharge
• Hot flashes/night sweats
• Dry mouth
• Headaches
• Inflammation/fluid buildup
• Dizziness
• Changes in taste (what can only be described as metallic)
• Loss of sex drive/pain
• Digestive problems: bloating, constipation, diarrhea, nausea
• Sleep disturbance: insomnia, inability to fall back asleep 

What in the actual hell was happening? In hindsight, I probably shouldn’t have complained as much as I did. There are reportedly over 30 symptoms associated with peri and menopause, so… #winning? Besides, Black, Hispanic, and Indigenous women, on the whole, report more severe menopausal symptoms than White women. Although Asian women are less likely to experience hot flashes and night sweats—something, apparently, no one bothered to tell my Japanese side—I continue to swelter day and night (although the Give-A-Care cooling pajamas do help here).

To paraphrase the divine Jennifer Coolidge in season 2 of White Lotus: “These menopause symptoms are trying to murder me.”

At my hospital’s breast cancer centre, the social worker charged with caring for younger patients divulged that in consults, she regularly pointed to me as an example of the multitude of side effects that can come from treatment. And while I respect her transparency with other patients—something I feel my oncologist omitted entirely when it came to my own hormone therapy—I can’t help but feel that I was unwittingly made a poster girl for early menopause problems. 

CANCER-INDUCED MENOPAUSE IS NOT LIKE THE OTHERS

When I first shared how difficult I was finding things with my aunt, she responded with the countless ways she had suffered through her own [non-cancer-related] menopause (both peri and post). No doubt she was trying to demonstrate that she could relate, which, of course, I loved her for. But instead of normalizing my situation, it felt pretty invalidating.

After all, the vast majority of women will kick into menopause gradually, over the course of many, many years. Their bodies aren’t forced to cut off all their estrogen in one fell swoop. One of my breasties, in contrast, recalled how she’d gotten her period the morning of her first Zoladex injection and it trickled to nothing that very day, like a tap being turned off. Or perhaps more aptly, like that friend who cancer-ghosted you, never to be seen again. 

All to say that “natural” menopause that follows the cycle of life, and the chemically induced version are, in my view, simply not the same. My aunt had already had a family, raised her children, and crucially, had a whole group of girlfriends in a similar stage to commiserate with. 

THE SOCIAL ISOLATION OF BEING THE ONLY ONE

According to the Menopause Foundation of Canada, most women reach menopause between the ages of 45 and 55, but it can occur as late as 60. One in 100 women experiences menopause before the age of 40, and one in a thousand before the age of 30. 

I don’t know how many young breast cancer patients experience menopause or related symptoms from treatment but when it comes to Rethink’s own community, a full 88% said they’d been thrown into early menopause with their diagnosis. Many added that going through menopause well ahead of their peers and friends only compounded that sense of loneliness. (Same, girl, same.) 

I thought the social isolation would ease when my friends aged into menopause themselves. And, to some degree, it did; I gladly impart tips and advice like the quasi menopause guru that I am. 

But, if I’m being honest, there’s also a bit of resentment. Because as hellish as it may be to age into your menopause years, there’s arguably never been a better time for it. 

MENOPAUSE IS HAVING A MOMENT

In case you haven’t noticed, there’s been a sea change in how society has come to view, well, “the change.” No longer taboo, Hollywood A-listers like Gwyneth Paltrow, Halle Berry, and Naomi Watts now talk openly about their menopause problems (all while shilling their own line of products as a solution). 

My FYP is filled with a “menoposse” of medical influencers who’ve amassed millions of followers (and, I presume, dollars) with the promise that women can thrive through menopause. 

Closer to home, Toronto’s Mount Sinai Hospital blanketed the city last fall with ads in support of their ‘Hot and Bothered’ campaign. Their goal was to validate and reframe the menopause experience while raising awareness and funds for its Centre for Mature Women’s Health. 

A worthy cause, to be sure, but hardly one I could relate to given my um, shall we say, ‘less-than-mature’ age at diagnosis. Those aforementioned celebs, doctors, and yes, even my peers wax poetic about hormone replacement therapy as some kind of panacea for menopause suffering. Just not for most young breast cancer patients who must do everything possible to block estrogen and progesterone in their bodies. Which means that women like me are left to suck it up for a longer period, with more severe symptoms, and yet, fewer solutions. 

Don’t get me wrong. I’m grateful that society is getting to a place where menopause isn’t quite so shrouded in shame. But it’s taken generations of women suffering to get here, and I long for the same recognition, consideration, and yes, therapeutic alternatives for those who are forced to manage menopause on top of a life-threatening diagnosis. 

One individual from Rethink’s community described this state of being pretty succinctly: “With cancer treatment, chemo, and radiation, there was a timeline. I knew when I’d have those treatments and [the] end date. With menopause, it does what it wants when it wants. It affects literally everything… It’s random and non-stop and feels like there is no end in sight.”  

I wish I had more to offer the Give-A-Care community. I wish I could tell you there’s a map for this wilderness, but there isn’t. Trust me, I’ve looked. But you are not alone in it either. I see you. 

Hang in there, love. You are doing great. I swear. — Aya McMillan

Aya McMillan is a Key Collaborator for Rethink Breast Cancer. Since her IDC diagnosis in 2017, Aya has supported the community through fundraising, peer mentoring, and sharing her story in research papers, panels, blogs, and interviews — all in the hope of making the next girl’s cancer journey a little more bearable.