Menopause is intimately connected to ageing in women. Where men expect a gradual change as they age, women anticipate an abrupt loss of hormones that heralds sudden changes to how they look and feel, with a loss of status as they feel their physical attraction decline. Breast cancer treatment can accelerate this change, which is frequently unexpected. Women expect potentially disfiguring surgery, hair loss and nausea through chemotherapy, and soreness and fatigue through radiotherapy, but menopausal problems, such as hot flushes and dry vagina, may not be expected and can be both troubling and long lasting. 70% women have menopausal difficulties after breast cancer, of whom 95% have hot flushes. These can last more than five years in a third of women. Most of those with hot flushes also have night sweats and disturbed sleep, with 72% women experiencing hot flushes also recording disturbed sleep. Worryingly, in one survey 30% women said they had considered stopping taking adjuvant hormone therapy because of their hot flushes. It is known that only 50% women adhere to a full five years of adjuvant hormone therapy, resulting in a 30% increase in breast cancer mortality. In the UK, the National Cancer Research Institute Clinical Studies Group for breast cancer has set up a sub group to stimulate new research into this area. This presentation will share some of the UK current thinking and research around managing menopause in women who have had breast cancer.