Menopause After Ovarian Cancer: Ways to Manage Symptoms

For many ovarian cancer survivors, menopause isn’t something that happens gradually over time. It often arrives suddenly—triggered by chemotherapy, surgery, or medication—and brings with it a whirlwind of physical and emotional changes. And when systemic hormone therapy isn’t recommended after cancer, it can feel like you’ve been left without a roadmap.

That’s why the National Ovarian Cancer Coalition (NOCC) created this special three-part Teal Talk – An Ovarian Cancer Podcast series on menopause. In Part 2, Menopause After Ovarian Cancer: Ways to Manage Symptoms, Dr. Stephanie McNally offers practical, compassionate guidance for those managing menopause naturally—and for those exploring safe, personalized options with their providers.

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Why hormone therapy isn’t always an option

Hormone therapy is often used to relieve menopause symptoms. However, for those who have been treated for hormone-sensitive cancers or ovarian cancer, systemic estrogen is not always safe.

That does not mean your symptoms should be ignored.

“There are more tools available now than ever before to help women manage menopause symptoms,” says Dr. McNally.

Systemic hormone therapy (oral or patch-based) may carry increased risks for some survivors. Local estrogen therapy, such as low-dose vaginal creams or rings, is often safe and effective even for those with hormone-related cancers. Still, every plan should be personalized.

Reclaiming comfort: Pelvic floor therapy

Let’s talk about a therapy that’s changing lives but still flies under the radar: pelvic floor therapy.

Survivors who’ve undergone surgery, radiation, or years of hormonal disruption may experience:

• Pelvic pain or tightness
• Painful intercourse
• Vaginal dryness
• Urinary incontinence or urgency
• Lower back discomfort
  

Pelvic floor physical therapists are specially trained to work with these muscles and tissues, helping improve strength, flexibility, blood flow, and nerve response.

“It’s not just a Kegel because it’s all connected,” Dr. McNally explains. “Pelvic floor therapists assess your whole core and vaginal function.”

Therapists may also introduce vaginal dilators, which are gentle, silicone devices that help restore elasticity to vaginal tissue in a slow, safe way.

Managing menopause naturally: Relief without hormones

There are many safe, non-hormonal ways to address treatment-induced menopause symptoms. These options can improve daily comfort, boost mood, support intimacy, and promote long-term wellness without increasing your risk.

1. Vaginal Moisturizers & Lubricants

One of the most overlooked menopause symptoms is vaginal dryness, which can cause itching, irritation, or pain during intimacy.

• Moisturizers are used two to three times per week to hydrate vaginal tissue over time.
• Lubricants are used as needed for sexual activity or dilator use.

“You want a product that has a pH that’s similar to the vaginal environment and a low osmolality,” says Dr. McNally.

2. Non-Hormonal Prescription Options

Not ready for hormones? There are FDA-approved medications that work by targeting the brain’s thermostat to ease hot flashes, night sweats, and mood changes.

Options include:

• Fezolinetant (Veozah): A new class of non-hormonal drug specifically for hot flashes
• SSRIs/SNRIs: Originally developed for depression, but shown to help with hot flashes, mood, and sleep
  

“There are FDA-approved medicines that are not hormone therapy that work centrally in the brain to help with vasomotor symptoms and sometimes mood,” says Dr. McNally.

3. Complementary Therapies That Make a Difference

Your body and mind deserve care on every level. Many survivors find comfort in evidence-backed integrative practices that reduce menopause symptoms and restore well-being.

Options to explore:

• Acupuncture: Reduces frequency and severity of hot flashes
• Yoga, tai chi, and mindfulness meditation: Improve mood, balance, and sleep
  
• Cognitive behavioral therapy (CBT): Proven to reduce hot flash distress, anxiety, and insomnia
• Nutrition and strength training: Help counteract bone loss and weight gain
  

“When I talk about managing menopause naturally, I want to support the entire individual, not just the symptom,” Dr. McNally explains.

Take this with you: You have more control than you think

Menopause can feel like it takes over your body. But you can take back the narrative. If you are a survivor navigating menopause after ovarian cancer, there is hope, support, and science-backed solutions available to you.

Let’s recap:

• You do not need hormones to feel better.
• There are safe, effective alternatives, including non-hormonal medications and pelvic floor therapy.
• Natural solutions can improve intimacy, emotional health, sleep, and overall wellness.
• You deserve a provider who listens and offers solutions tailored to your survivorship journey.
  

“Be bold and be brave,” Dr. McNally says. “Find your voice, your words, and then find that provider that’s going to listen. Do not suffer in silence.”