‘Medically Induced Menopause Triggered Pain No One Warned Me About—Here’s How I Overcame It’
See Shauna's inspiring story, and the one thing she wishes every woman knew
I went into my first mammogram in 2020 at 43, aware of my family history of cancer. Two aunts on my father’s side had been diagnosed with breast cancer after menopause. One survived, one did not. When the results came back they showed suspicious areas and dense breast tissue, I was categorized as high risk for breast cancer myself. I had no idea that it would eventually lead to surgery, medically induced menopause and a new health issue I never expected.
When a routine cancer screening became something more
After my initial screening, I began having mammograms every six months so doctors could closely monitor my health. In 2021, as the world began to open back up after COVID, I was called in for an MRI. Part of me hoped it was simply routine monitoring and that nothing would show up. But deep down, I was worried.
The next day, I was driving home from work when my phone rang. I didn’t recognize the number. Within minutes, a doctor told me, “We got your results back. They did find a tumor.” The words landed like a gut punch.
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About an hour later, a breast surgeon explained that my cancer was considered moderate risk. “We wouldn’t call it aggressive,” she said, “but we wouldn’t call it something that’s growing slowly either.” Processing that news alone in my car felt surreal. But once I told my husband, I felt supported and ready to move forward.
A double mastectomy awaited me
My husband attended my oncologist appointment with me as we began making decisions about treatment. Up until that point, most of my care had been with my breast surgeon. While the tumor itself was very small, there were additional abnormal cells in the surrounding area. Removing all of it with a lumpectomy would leave my breast misshapen, so my doctor recommended a mastectomy.
I decided to have a double mastectomy. I knew I never wanted to go through biopsies again. They were extremely painful and emotionally difficult, and I didn’t want to face that experience in the future. After surgery, the tumor and surrounding tissue were sent to my oncologist, and I mentally prepared myself for what was next: chemotherapy.
A choice I did not expect
At first, the plan was traditional chemotherapy. My husband and I had already prepared our children, explaining that this was what I would likely be going through and that I was going to be okay.
My oncologist walked us through my recurrence risk and treatment options. She explained that my cancer was primarily estrogen driven. With just the double mastectomy, my risk of recurrence was about eight percent. With additional treatment, it could drop to about three percent.
I had a choice: chemotherapy or medically induced menopause. Because I was already in perimenopause, she explained that women in my situation often do very well with estrogen suppression alone.
I was shell shocked. I had already wrapped my head around going through chemotherapy, and suddenly there was another option. After checking my hormone levels and taking time to think it through, I made my decision. I knew that if I went through chemotherapy, I would likely go into menopause anyway. Menopause isn’t easy, but it’s something I’d experience eventually anyway. For me, it felt like a no-brainer to better reduce my long-term risk of cancer.
I chose medically induced menopause with hormonal therapy and began monthly injections of a synthetic hormone known as Zoladex in July 2021. After a couple of years, I switched to a higher dose every three months. I continued treatment until June 2025.
What is medically induced menopause?
“Medically induced menopause happens when medical treatment or surgery causes the ovaries to stop producing hormones earlier than normal,” explains Stephanie Ferguson, MD, ob-gyn and medical advisor to Uresta. “This leads to the end of menstrual periods and fertility. Unlike natural menopause, which occurs gradually around age 51, medically induced menopause often happens suddenly and can cause stronger symptoms.” (Learn more about when menopause usually starts.)
Life after medically induced menopause was harder than expected
About a month after starting the injections, the first time my husband and I tried to have sex, it was shockingly painful. Vaginal dryness made intimacy a challenge. And after cancer, my mind immediately went to worst-case scenarios. But then I realized it could actually be my medically induced menopause.
“Vaginal atrophy [also known as genitourinary syndrome of menopause or GSM] happens when the vaginal lining thins out due to decreased estrogen levels associated with menopause,” explains Lennox Hoyte, MD, MSEECS, a fellowship-trained, board-certified specialist in female pelvic medicine and reconstructive surgery. “Menopause leads to decreased estrogen levels, and decreased estrogen levels lead to vaginal atrophy (thinning of the vaginal lining).”
I was far from the only woman experiencing vaginal atrophy
I started searching for online support groups and found countless women describing the same experience, including women who had gone through chemotherapy. Some recommended pelvic floor therapy, so I tried it for three months. While the therapist was knowledgeable, the focus was on strengthening my pelvic floor, which didn’t address the root of my pain.
In the breast cancer community, hormone replacement therapy (HRT) has long been considered controversial. But in these groups, I kept seeing women share that their doctors had prescribed it. When I brought up using estradiol (a natural estrogen) with my doctor to help with the pain and vaginal dryness, she explained that the medication I was on at the time blocked any form of estrogen. If we switched me to another drug, tamoxifen, she said I could safely use vaginal estradiol. Because it’s a very small, localized dose, studies show it stays in the vaginal tissue and does not circulate through the body or increase the risk of recurrence.
What is vaginal estrogen?
Since starting vaginal estrogen in October 2025, I’ve noticed improvement when it comes to intercourse and overall vaginal and vulval health. While I’m not “back to normal,” I can say that I feel very hopeful knowing I have something that is proven to help women who have gone through—not just breast cancer, but menopause. I just wish I had been able to use it sooner.
“Estradiol can improve vaginal health and comfort by strengthening and thickening the vaginal lining, improving elasticity and lowering vaginal pH to reduce sensitivity,” says Dr. Ferguson. “It also helps the vaginal lining produce natural moisture.”
“Vaginal estrogen is effective at low doses, limiting overall estrogen exposure, and is available as creams, tablets, rings or inserts applied directly to the vagina,” adds Dr. Ferguson. “Studies show that using vaginal estradiol twice a week can significantly reduce dryness and pain during sex, improving comfort, arousal and sexual satisfaction.”
I want other women to know they have options
Through it all, my husband has been incredible. I feel fortunate to have an understanding partner who has prioritized communication, connection and intimacy. Today at 49, I hope my story empowers all women, not just those battling cancer, to stay informed about menopause and seek treatment that truly supports them in every way.
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