Navigating Menopause After Cancer

Ah, this was a great start to such an important episode! I literally did no planning AT ALL! I just wanted to know from Dr Jordan Emont, our guest on today’s show, if there is a common question he gets asked by his patients in his clinic. And after getting such lovely personal insights into Jordan’s life, we ended up having an evidence-based conversation about testosterone after cancer, especially for people navigating menopause after breast cancer. We dig into why access in the US is getting harder not easier and how clinicians think about balancing quality of life with safety when the data is still limited. This episode is so true to all the conversations we have on this podcast because it sits right in the middle of a real-world clinical grey area: patients want relief, oncologists want reassurance, and doctors are trying to make thoughtful decisions without perfect long-term trials. Jordan also shares how this topic is evolving in guidelines, why he thinks testosterone can help some people stay on aromatase inhibitors, and where caution still makes sense. Episode Highlights: 00:00 Intro 09:57 Challenges in Women's Health Narratives 13:37 Differences in hormone treatments 17:25 Aromatase inhibitors in breast cancer 18:55 Discussing testosterone for cancer survivors 23:15 Testosterone use and sexual health 25:54 Discussing health and energy levels 30:10 Long-term safety of testosterone use 32:10 Checking testosterone levels timing 35:58 Balancing safety and quality of life 40:54 Testosterone's role in breast cancer 44:39 Discussing hormone therapy benefits 48:47 Testosterone use after prostate cancer Here are Dr Emont’s links: Here is his Substack about testosterone this which he’s made free to access: https://drjordanemont.substack.com/p/testosterone-after-breast-cancer Here’s Dr Sarah Glynne's paper on testosterone to treat menopausal symptoms: https://journals.lww.com/menopausejournal/fulltext/10.1097/gme.0000000000002777~use-of-transdermal-testosterone-to-treat-menopausal-symptoms Connect with us: For more information and resources, visit our website: www.menopauseandcancer.org Follow us on Instagram @menopause_and_cancer Find us on YouTube: http://www.youtube.com/@NavigatingMenopauseAfterCancer Join my NEW blog ‘Still Becoming’ on Substack: https://substack.com/@danibinnington?... Buy my book ‘Navigating Menopause After Cancer’: https://amzn.eu/d/07dUoYBb Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

“Night sweats. I cannot go on like this. What are people taking who can’t take HRT?” That was a recent post in our community and the replies came flooding in. Venlafaxine. Oxybutynin. Acupuncture. HRT. Lifestyle changes. So many people trying different things to manage debilitating hot flushes and night sweats after cancer. But increasingly, two new names are appearing in these conversations: fezolinetant (Veoza) and elinzanetant (Lynkuet). These newer non-hormonal medicines have been specifically developed to treat menopausal hot flushes and night sweats. But what are they? How do they work? And, crucially for our community, can you take them after cancer? I’m joined once again by the wonderful Dr Zoe Schaedel, NHS GP, menopause specialist and sleep expert, to give us a practical roadmap. We discuss: How fezolinetant and elinzanetant work and why they're different from some of the older non-hormonal options What we currently know about their use following different cancers Side effects, contraindications and the concerns you've perhaps heard about How to actually access them Why access can vary across the NHS What your local formulary and its “traffic light” classification can tell you Whether your GP can prescribe or whether you may need a menopause specialist or oncologist And for our listeners outside the UK, we also talk about some of the barriers to accessing these medicines elsewhere, including the frustrating issue of insurance coverage in the US. We’ve been following this story for a while… Way back in Episode 46, I spoke to Professor Waljit Dhillo, one of the researchers behind this new approach to treating hot flushes. At the time, these medicines felt like an exciting glimpse into the future. Well, the future is here. People in our community are now taking them and we're hearing experiences like this: “Veoza!! After a year on these, I am starting to get a few again, but still a million times better than before!” So this episode moves the conversation from “What might be coming?” to: Could this be an option for me and how do I get it? Episode Highlights: 00:00 Intro 06:23 Treating menopause with neurokinin blockers 09:36 Navigating menopause after cancer 12:02 New menopause treatment options 15:15 GP and menopause specialist roles 19:14 Discussing Vioza and cancer treatment suitability 21:59 Discussing Vyosa and cancer treatment safety 24:47 Observing NICE approval process 29:46 Helping patients stick with treatment 30:26 Discussing Vioza side effects 33:41 Discussing Vioza safety concerns 40:00 Access to new prescription approval 40:47 Understanding UK Medication Access Here is more info about Dr Zoe Schaedel: https://www.mylahealth.co.uk/ Other episodes mentioned today: Ep 124 “How to Fix Your Sleep Issues – From Medication to Mindfulness” Ep 143 “Alternatives to HRT. Prescribable Non-Hormonal Options” Ep 146 “Your Plan For Better Sleep.” And have a listen to Episode 46: A Revolutionary Non-Hormonal Treatment for Hot Flushes! with Professor Waljit Dhillo to hear where this story began. As always, this podcast is for information and education and isn't a substitute for personalised medical advice. Please discuss your individual circumstances and treatment options with your healthcare team. Connect with us: For more information and resources, visit our website: www.menopauseandcancer.org Follow us on Instagram @menopause_and_cancer Find us on YouTube: http://www.youtube.com/@NavigatingMenopauseAfterCancer Join my NEW blog ‘Still Becoming’ on Substack: https://substack.com/@danibinnington?... Buy my book ‘Navigating Menopause After Cancer’: https://amzn.eu/d/07dUoYBb Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

Making difficult decisions after cancer isn’t something we talk about enough. The kind where there isn’t a clear “right” answer. Where every option comes with trade-offs. Where you’re weighing up your long-term health, your quality of life… and sometimes, parts of your identity. In this episode, I’m joined by the incredible Jen Delvaux — cancer survivor, podcast host, and founder of a thriving community in the US. Jen’s story is uniquely complex, with both her and her husband navigating cancer diagnoses, bringing a deeply personal perspective on survivorship. Together, we explore the realities of life after treatment — including sexual health, bone health, basically - all aspects of the often-overlooked impact of treatment-induced menopause. You can find Jen here: https://www.jendelvaux.com/ And this is her podcast: https://podcasts.apple.com/us/podcast/not-today-cancer/id1436449587 and Instagram https://www.instagram.com/jendelvaux Podcast Episode Mentions: Episode 215 - https://podcasts.apple.com/gb/podcast/episode-215-bone-health-after-cancer-menopause-what/id1631842514?i=1000764218500 Episode 113 - https://podcasts.apple.com/gb/podcast/ep-113-the-impact-of-endocrine-disruptors-on/id1631842514?i=1000663146637 Get a copy of Dani’s book here: https://amzn.eu/d/bjU18OM Episode Highlights: 00:00 Intro 06:09 Living with cancer's emotional weight 08:19 Discussing cancer treatment decisions 12:21 First experience with symptom relief 14:08 Diet and menopause insights 17:17 Balancing health and happiness 19:26 Living life to the fullest 23:26 Coping with cancer as parents 28:43 Discussing osteoporosis diagnosis 32:04 Planning post-treatment support 39:30 Discussing difficult health decisions Connect with us: For more information and resources, visit our website: www.menopauseandcancer.org Follow us on Instagram @menopause_and_cancer Find us on YouTube: http://www.youtube.com/@NavigatingMenopauseAfterCancer Join my NEW blog ‘Still Becoming’ on Substack: https://substack.com/@danibinnington?... Buy my book ‘Navigating Menopause After Cancer’: https://amzn.eu/d/07dUoYBb Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

Let's stop the toxic positivity! Just because active cancer treatment may have ended, we don't have to be endlessly positive and grateful for it all. What comes next can be hard. That's why I invited Jessica Zucker, clinical psychologist, author of the bestselling book ‘Normalize It: Upending the Silence, Stigma, and Shame that Pervade Women's Lives’ and breast cancer survivor, to talk about the long silence that often follows women through miscarriage, breast cancer, tamoxifen and medical menopause. Jessica and I talk about what it means to live with the aftermath of treatment, when the symptoms linger, the uncertainty stays, and the pressure to keep smiling can feel almost unbearable. We also discuss the hidden toll of tamoxifen, the emotional impact of medical menopause, and why phrases like “you’re a warrior” or “at least” can sometimes do more harm than good. Jessica was so open about how even she, as a psychologist, found the experience of tamoxifen and long-term side effects surprising and difficult. We talk about exhaustion, brain fog, loss of creativity, grief, perfectionism and the illusion of control, and why so much of this still goes unsaid. This is a conversation about naming the harder parts out loud, and making space for honesty, nuance and connection. Key topics The pressure to stay positive after cancer and the harm of toxic positivity Jessica’s experience of tamoxifen and medical menopause Exhaustion, brain fog and the emotional impact of treatment side effects Grief, uncertainty and the pressure to make the “right” decisions Find Jessica’s fantastic book ‘Normalize It: Upending the Silence, Stigma, and Shame That Shape Women's Lives’ here https://a.co/d/0hLfwz2z Episode Highlights: 00:00 Intro 04:07 Discussing the stigma of grief 09:08 Getting a life-changing diagnosis 12:43 Discussing cancer diagnosis and treatment 13:54 Discussing tamoxifen 23:10 Therapists seeking therapy for themselves 24:38 Coping with tamoxifen side effects 28:43 Pressure of Being a Cancer Warrior 31:57 Controlling health outcomes reality check 37:30 Coping with grief and aging 42:58 Sharing personal challenges for impact A little favour... If you enjoy listening each week, I'd love to ask one small favour. Would you consider leaving a review on Apple Podcasts? Every review helps more people discover the podcast, and with your support we've now grown into one of the top 1% of podcasts worldwide. That's something we've achieved together, and I'm so incredibly grateful. Leave a review here: Apple: https://podcasts.apple.com/gb/podcast/navigating-menopause-after-cancer/id1631842514 Spotify: https://open.spotify.com/show/3OhAwupemqzdI6sCXCZLSX Thank you for being part of this wonderful community. x Connect with us: For more information and resources, visit our website: www.menopauseandcancer.org Follow us on Instagram @menopause_and_cancer Find us on YouTube: http://www.youtube.com/@NavigatingMenopauseAfterCancer Join my NEW blog ‘Still Becoming’ on Substack: https://substack.com/@danibinnington?... Buy my book ‘Navigating Menopause After Cancer’: https://amzn.eu/d/07dUoYBb Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

Welcome to the first guest episode of Navigating Menopause After Cancer. In the last two episodes, I shared why the podcast has entered a new chapter and reflected on the power of stories: how they help us navigate uncertainty, create connection and remind us that we're never alone. Today's conversation is a really beautiful example of exactly that. I'm joined by Michelle and Becky, two incredible women diagnosed with anal cancer back in 2024. I learned on a previous episode on anal cancer (episode 209) that anal cancer is often surrounded by stigma, shame, embarrassment and silence. It's a cancer that simply isn't talked about enough. And treatment for anal cancer can also induce menopause - so we have to talk about it! Yet despite receiving the same diagnosis at almost the same time, Michelle and Becky's experiences were very different. Michelle openly shared her diagnosis but struggled to find someone else living with anal cancer who truly understood what she was going through. Becky found support from others with anal cancer from the very beginning, but didn't feel comfortable telling many of the people around her she had anal cancer, choosing instead to say she had bowel cancer. Together, they share an honest conversation about diagnosis, treatment, menopause, intimacy, identity, stigma and why sharing our true stories matters. One of my favourite parts of this story actually happened away from the recording. After meeting Michelle in person, I introduced her to Ali who had previously shared her own anal cancer story on this podcast... and something rather special has grown from that connection. Episode Highlights: 00:00 Intro 04:01 Finding support after cancer diagnosis 11:19 Dealing with surgical menopause 13:22 Post-treatment challenges and loneliness 19:17 Rebuilding confidence after cancer 22:01 Adjusting to life after stoma surgery 23:59 Dealing with radiation side effects 28:56 Discussing anal cancer stigma 33:01 Connecting with others on TikTok 40:06 Cancer treatment challenges and recovery 45:06 Returning to fitness after radiotherapy 47:49 Finding support during cancer Links: Find Michelle & Ali’s new anal cancer support here: The Brave Behinds https://www.instagram.com/thebravebehinds/?hl=en Macmillan Anal Cancer Support Forum: https://community.macmillan.org.uk/cancer_types/anal-cancer-forum Ali Stripling’s episode: Beyond the Pink - Anal Cancer, Menopause & Awareness Day: https://youtu.be/V0_5MedxjKw?si=QB-i9XO1uWhQ1Mwf This podcast episode was supported by an unrestricted grant from Incyte Biosciences. Incyte had no involvement in the development, content, or editorial review of the activities associated with this initiative.