Menopause care after cancer.
Non-hormonal. Coordinated. Compassionate.

Why this matters

Cancer treatment frequently triggers menopause — sometimes abruptly through chemotherapy, ovarian suppression, or surgery. The symptoms are often more severe than natural menopause, and the standard first-line option (systemic estrogen) is typically off the table, particularly after estrogen-receptor-positive breast cancer. That does not mean nothing can help.

Non-hormonal options Kindr providers prescribe

• Fezolinetant (Veozah) — non-hormonal NK3 receptor antagonist, FDA-approved 2023 for moderate-to-severe vasomotor symptoms.
• Paroxetine (Brisdelle) — only SSRI FDA-approved specifically for hot flashes. Note: not appropriate alongside tamoxifen.
• Venlafaxine, escitalopram — SSRIs/SNRIs commonly used off-label and supported by evidence.
• Gabapentin — particularly useful when sleep is the dominant problem.
• Vaginal moisturizers, hyaluronic acid suppositories, ospemifene — for genitourinary symptoms when local estrogen is not appropriate.
• Cognitive behavioral therapy for insomnia (CBT-I) — evidence-based first-line for chronic insomnia.

Coordination with your oncology team

Kindr providers will request that you stay connected to your oncology team, particularly if you are on tamoxifen, an aromatase inhibitor, or other adjuvant therapy. Some non-hormonal medications interact with these regimens — paroxetine reduces tamoxifen efficacy, for example — and we work around those constraints rather than ignoring them.

What we will not do

Kindr will not prescribe systemic estrogen to women with a history of estrogen-sensitive breast cancer or other contraindicated cancers. Decisions about local vaginal estrogen in survivors are made carefully and in coordination with the oncology team.

Related

Fezolinetant · Paroxetine · Symptoms · Mental Wellness