- Cancer Information
- Managing side effects
- Fertility and cancer
- Treatment side effects and fertility
- Specific challenges after treatment
Specific challenges after treatment
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
- Premature 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 because of the damage caused by the treatment. This is known as acute ovarian failure. You will have occasional or no periods, and symptoms similar to menopause (see below), before regular periods return. If ovarian failure continues for several years, it is less likely that your ovaries will work normally again.
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.
Premature menopause could 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.
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) – previously known as hormone replacement therapy or HRT – 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.
For more information, talk to your doctor or ask for a referral to a specialist menopause clinic.
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 Finding Calm During Cancer podcast.
Menopause can cause the bones to weaken (osteoporosis). Talk to your doctor about having a bone density test and what you can do to maintain strong bones. Regular weight-bearing exercise and eating foods high in calcium can help keep your bones strong. Healthy Bones Australia has more information – call 1800 242 141.
If treatment causes retrograde ejaculation, 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.
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.
Sometimes, erection problems can be permanent. If you are not able to have penetrative sex, you may be able to have testicular sperm extraction to help you conceive.
Podcast: Meditation and Relaxation
Prof Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne and Director, Gynaecology Research Centre, The Royal Women’s Hospital, VIC; Dr Sally Baron-Hay, Medical Oncologist, Royal North Shore Hospital and Northern Cancer Institute, NSW; Anita Cox, Cancer Nurse Specialist and Youth Cancer Clinical Nurse Consultant, Gold Coast University Hospital, QLD; Kate Cox, McGrath Breast Health Nurse Consultant, Gawler/ Barossa Region, SA; Jade Harkin, Consumer; A/Prof Yasmin Jayasinghe, Director Oncofertility Program, The Royal Children’s Hospital, Chair, Australian New Zealand Consortium in Paediatric and Adolescent Oncofertility, Senior Research Fellow, The Royal Women’s Hospital and The University Of Melbourne, VIC; Melissa Jones, Nurse Consultant, Youth Cancer Service SA/NT, Royal Adelaide Hospital, SA; Dr Shanna Logan, Clinical Psychologist, The Hummingbird Centre, Newcastle West, NSW; Stephen Page, Family Law Accredited Specialist and Director, Page Provan, QLD; Dr Michelle Peate, Program Leader, Psychosocial Health and Wellbeing Research (emPoWeR) Unit, Department of Obstetrics and Gynaecology, The Royal Women’s Hospital and The University of Melbourne, VIC; Pampa Ray, Consumer; Prof Jane Ussher, Chair, Women’s Health Psychology, and Chief Investigator, Out with Cancer study, Western Sydney University, NSW; Prof Beverley Vollenhoven AM, Carl Wood Chair, Department of Obstetrics and Gynaecology, Monash University and Director, Gynaecology and Research, Women’s and Newborn, Monash Health and Monash IVF, VIC; Lesley Woods, 13 11 20 Consultant, Cancer Council WA.
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