Background. Breast cancer is the most common cancer in women. Menopausal symptoms, which can highly reduce quality of life in women of all ages, are frequent side-effects of systemic treatment of early breast cancer whether treated by hormonal or cytotoxic therapy. Methods. The article presents literature review of the causes, assessment and management of menopausal symptoms in breast cancer patients. Results. There are a number of non-hormonal drugs effective in treating vasomotor symptoms, and same alternative therapies, such as black cohosh, phytoestrogens, homeopathy, acupuncture, yoga and behaviour strategies. The decision, whether and which pharmacologic or non-pharmacologic treatment to choose, depends on symptoms and on patient wishes. The most effective drugs for reducing hot flashes are venlafaxine, paroxetine and gabapentin, unfortunately, the side effects are common. Vaginal estrogens are the most effective for treating atrophic vaginitis, but the safety in breast cancer patients is not established. Conclusions. Menopausal symptoms after breast cancer are severe and frequent and significantly reduce quality of life. Unfortunately, the possibility of treatment is limited.