Possible side effects of
hormonal treatment

There are a number of side effects that may be associated with hormonal treatment based on their actions in the body. Knowing about these side effects and what may be done to help manage them can help you cope. Side effects may vary depending on the particular hormonal treatment used.

Some common side effects include:

• Hot flashes
• Effects on bone
• Joint problems
• Vaginal and uterine changes

Hot flashes

Hot flashes are the most common side effect of hormonal treatment. Hot flashes have a lot to do with how estrogen works in your body, but other factors can affect your temperature control. Something that causes a hot flash is called a trigger. The following are some tips for helping to deal with hot flashes.

• Avoid triggers
  If you can identify the things that trigger your hot flashes, you've taken the first step in getting the upper hand. Try to keep a record of when your hot flashes occurred, what you were eating or doing, or how you were feeling at the time. Here are some hot flash triggers you should try to avoid:
  • Alcohol
  • Hot food
  • Spicy food
  • Caffeine
  • Diet pills
  • Hot rooms
  • Hot tubs
  • Saunas
  • Hot showers
  • Smoking
• Reduce stress
  Many women find stress to be a major trigger for hot flashes. You might try to ease the pressure by practicing the following tips:
  • Give yourself more time to plan work, outings, or shopping.
  • If you have a busy schedule, give yourself a chance to relax and cool off.
  • Plan your schedule to avoid stressful situations when you're most likely to be in a sweat.

For more information about dealing with hot flashes, please visit the "All About Hot Flashes" page at www.breastcancer.org.

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Effects on bone

Monitoring and maintaining bone strength is important for all women. It is especially important for women with breast cancer on certain hormonal treatments. These treatments can have continuing effects on bone that may cause or put you at risk for bone loss, a condition called osteoporosis.

How certain hormonal treatments affect your bones depends on several factors, including:

• How strong your bones were before you were receiving breast cancer treatment
• Which types of breast cancer treatment you receive
• Your menopausal status

Bone mineral density (BMD) is a common measure of bone loss and refers to the amount of calcium you have in your bones. Because calcium makes your bones strong, doctors can use BMD to determine how likely it is that your bones will weaken. If you are taking hormonal treatment, or if you will be starting hormonal treatment, you may want to consider the following information:

Helping to keep your bones strong

Women can lose up to 20% of their bone mass in the five to seven years following menopause. People with osteoporosis are much more likely to suffer a fracture. Regardless of age, all women can reduce their risk of osteoporosis by:

• Eating a balanced diet rich in calcium and vitamin D
• Engaging in weight-bearing exercise, such as walking
• Avoiding smoking and excessive alcohol consumption
• Having a bone mineral density (BMD) test to help your doctor determine if you are at risk for osteoporosis

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Joint problems

Hormonal treatments can cause joint stiffness and related pain. Pain relief medications, including NSAIDs (nonsteroidal anti-inflammatory drugs), can help with this pain. If you don't get satisfactory pain relief, your doctor might prescribe other types of medicines.

In general, bone and joint pains also respond to heat, massage, swimming, and yoga.

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Vaginal and uterine changes

Vaginal dryness
Vaginal dryness caused by hormonal treatment can be uncomfortable. If you are sexually active, this condition may make it more difficult to relax, and as a result, intercourse may not be as enjoyable. You may find the following tips to be helpful:

• Use a water-based vaginal lubricant or moisturizer. These products are available without a prescription in many drugstores. Avoid using petroleum jelly, which may cause a vaginal yeast infection.
• Ask your doctor if there are samples you can try.

Vaginal bleeding
Although not common, unexpected vaginal bleeding can be a side effect of certain hormonal treatments for breast cancer. However, because it may be a sign of endometrial cancer, you should see your doctor immediately if you have any unusual vaginal bleeding while being treated with a hormonal treatment. Endometrial cancer can usually be detected in the early stages and is usually curable with surgery.

Vaginal discharge
You may notice a watery discharge while on hormonal treatment. The discharge might have an unpleasant smell. Discuss any vaginal discharge with your doctor.

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As always, talk to your doctor about managing side effects associated with treatment. Prescriptions or over-the-counter products may be available to help.