If you still have your reproductive organs, you may be able to conceive without medical assistance after cancer treatment. However, many people experience one of the following physical issues.
Learn more about:
- Acute ovarian failure
- Medically induced menopause
- Your feelings about early menopause
- Retrograde ejaculation
- Erection problems
Acute ovarian failure
While you’re having chemotherapy and radiation therapy, and for some time afterwards, the ovaries often stop producing hormones. This is known as acute ovarian dysfunction. You will have occasional or no periods, and symptoms similar to menopause, before regular periods return. If you have no periods for several years, your ovaries may not work normally again.
Medically induced menopause
Menopause is the end of menstruation (having periods). It usually happens between the ages of 45 and 55. Menopause before the age of 40 is known as premature menopause or premature ovarian insufficiency (POI), and before the age of 45 it is called early menopause.
A permanent end to your periods may occur immediately or many years after treatment depending on your age, type of treatment and the dose of any drugs you received. If the ovaries are surgically removed or too many eggs are damaged during treatment, menopause is permanent.
While premature menopause means you won’t ovulate, it may be possible to carry a baby if you have a uterus and have not had radiation therapy and use stored eggs or donor eggs. After spontaneous POI there is a small chance (5–10%) of becoming pregnant naturally because a remaining egg may mature and be fertilised by a sperm. The likelihood of getting pregnant after POI caused by cancer treatment is not known.
Menopause symptoms
Most menopause symptoms are related to a drop in your body’s oestrogen levels and might be more severe when menopause starts suddenly.
Common symptoms may include:
- a dry vagina
- hot flushes and night sweats
- aching joints
- changes in mood
- difficulty sleeping.
Menopause hormone therapy (MHT)
MHT was previously known as hormone replacement therapy or HRT. It may help treat menopause symptoms.
MHT replaces the hormones that the ovaries stop making, and can be taken as tablets, creams or skin patches. Taking MHT may increase the risk of some diseases.
If you were diagnosed with hormone-sensitive cancers such as breast cancer, you are advised not to take MHT, but there are other non-hormonal drugs available that can help.
Vaginal moisturisers and lubricants can help with vaginal discomfort and dryness. They are available over the counter from a pharmacy.
Learn more about emotions and cancer and complementary therapies.
Your feelings about early menopause
How menopause affects you can vary. For some, going through menopause earlier than expected may be upsetting. It may make you feel older than your age and affect your sense of identity.
For others, not having to worry about regular periods is a positive. It may take time to adjust to the changes you’re experiencing. Talk about how you’re feeling with a family member, friend or counsellor or sexual therapist. Some studies show that mindfulness exercises can also help.
Listen to our relaxation and meditation podcast.
Menopause can cause the bones to weaken (osteoporosis) and may increase your risk of heart disease. Talk to your doctor about having a bone density test and what you can do to maintain strong bones and a healthy heart. Doing weight-bearing exercise and eating calcium-rich foods can help keep your bones strong. Healthy Bones Australia has more information – call 1800 242 141.
Retrograde ejaculation
In some cases, after some surgeries or treatment, the nerves involved in ejaculation are damaged.
During orgasm, semen may go back towards the bladder instead of forward into the penis. This is called retrograde ejaculation.
If this happens, you may be given medicine to help the semen move out of the penis as normal. This may make it possible for you to conceive naturally.
Your fertility specialist can also collect some ejaculated sperm from the urine, which can be used to fertilise eggs during IVF.
Erection problems
Sometimes surgery damages the nerves that help control erections and causes erectile dysfunction. This is often a temporary problem.
The ability to have erections firm enough for penetration can continue to improve for up to 3 years after treatment has finished. Some people may not get strong erections again.
There are several medical options you can try. These include prescription medicine and erectile aids, which may make it possible for you to conceive naturally.
If you are not able to have penetrative sex, you may be able to have testicular sperm extraction to help you conceive.
→ READ MORE: Tips for managing fertility and treatment
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Dr Sally Reid, Gynaecologist and Fertility Specialist, Obstetrics and Gynaecology (Adelaide) and Royal Adelaide Hospital, SA; Dr Sarah Ellis, Clinical Psychologist and Postdoctoral Research Fellow, Kids Cancer Centre, Sydney Children’s Hospital and UNSW, NSW; John Booth, Consumer; Hope Finlen, Haematology Nurse Consultant, Gold Coast University Hospital, QLD; Dr Michelle Harrison, Medical Oncologist – Gynaecological cancers, Chris O’Brien Lifehouse, NSW; Melissa Jones, Nurse Consultant, Youth Cancer Service SA/NT, Royal Adelaide Hospital, SA; Dr Violet Kieu, Clinical Director, Melbourne IVF and Fertility Specialist, The Royal Women’s Hospital, VIC; Prof Declan Murphy, Consultant Urologist, Director – Genitourinary Oncology, Peter MacCallum Cancer Centre and The University of Melbourne, VIC; Stephen Page, Family and Fertility Lawyer, and Legal Practice Director, Page Provan, QLD; Ann Retzlaff, 13 11 20 Consultant, Cancer Council WA; A/Prof Kate Stern AO, Fertility specialist, Gynaecologist and Reproductive Endocrinologist, Royal Women’s Hospital and Melbourne IVF, VIC; Georgia Webster, Consumer.
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