Hormonal birth control after TNBC??

AnxietyGirl85

I've got a question about birth control for my fellow pre-menopausal ladies out there. Editing to make this a bit less wordy.

I'm 33 years old and six months out from treatment for TNBC. Prior to this diagnosis, I took a low-dose hormonal birth control pill for about a decade with great success. When I was diagnosed, I was told to stop taking it immediately, first because of the risk of blood clots from surgery, and then "yeah don't take it," no explanation (and the MO wasn't willing to discuss it at all).

So I stopped taking them before surgery and stayed off them. I have no kids and I'm not interested in ever having them, so I didn't do any fertility preservation before starting chemo, but I did use Zoladex for the duration to preserve ovarian function - I don't want kids, but I'm not keen on permanent menopause in my 30s, either.

Over the course of treatment, I spoke with two other MOs about hormonal birth control, one during chemo and one that I was assigned to afterwards. The first said that she had no problems with me taking it again once I finished treatment and my periods started again, because my cancer wasn't hormone-driven. The other was adamantly against it, no explanation, no discussion, just don't take it ever again no matter what (and she wouldn't listen when I tried to ask her about what the previous doctor said, she just became agitated with me). The options I was given by her were copper IUD or condoms, end of story.

After treatment, I went to see my usual doctor for my pap smear, and since she's the one that handles my birth control situation, I asked her what her recommendations were (she had all the info on my cancer diagnosis). I told her what the two MOs had said, and I asked her what she thought of a copper IUD, since I wasn't keen on the idea. She told me that she never recommends them, and she was concerned that I would have a lot of very heavy bleeding and cramping every month if I got one. I asked her about the Pill again, and she took a look at the type I was taking previously and said it was totally fine because I'd had hormone-receptor negative cancer and because I was then out of active treatment and in remission.

I saw my MO again the following week, got up the nerve to ask her again, having had two other doctors now tell me it was OK, and she snapped at me and told me no way, and she cut me off when I tried to ask why I was getting mixed messages from different doctors, she didn't want to discuss it, she didn't want her orders questioned, nothing.

Then in September, my periods came back (with a vengeance, might I add, ugh, I haven't had mood swings like this since I was a teenager).

Now, here I am, six months later, assigned to yet another new MO, and I figure I'll ask this one, too, see what she says. I had my appointment this morning, got my scan results (all clear), had a physical exam (all clear), and at the end of the appointment, I get up the nerve to ask about birth control, and she was like, "Oh yeah, you're hormone-receptor negative, it's fine." I was sure to mention to her that my previous MO had said, in no uncertain terms, that I could never take it ever again, and she was all like, "Well that's wrong." I explained about the two other doctors I'd asked about it who also said it was fine, and how confusing it was to get mixed messages, and she was like, "Now you have three doctors that say it's OK."

So long story short, I've spoken to four different doctors (three of whom are MOs), and one was adamantly against hormonal birth control post-TNBC (and refused to explain why), but the other three were A-OK with it. I feel like my moods would be more stable if I started taking it again, and it would be a load off my mind for now, at least. I'd get my tubes tied now but after a year of being picked apart by doctors and all the awful experiences I've had with dealing with them, I'd really like a break from them for a while, I don't want more surgery right now, I'm trying to get back to work and get my life back together all by myself with no help, it's a whole thing, and being able to take the Pill again, even just temporarily, would be one less thing on my mind.

What has everyone else's doctors had to say about TNBC and hormonal birth control?? Are they even willing to talk about birth control at all?? Is anyone else here taking the Pill again, or is everyone using some other form of birth control?? I'd love some thoughts, please and thank you.

Sam0623

I have not spoken with my MO about this yet, but my gynecologist was very hesitant to prescribe me any hormonal birth control. I'm young like you, 33, and my periods came back about 7 months after my last zoladex injection.

I think the hesitation doesn't come from this triple negative cancer, but because of the concern that long term use of hormonal birth control might increase the risk of developing a secondary, hormone driver cancer in the future. There have been some studies on this that show a small increase in risk, but our overall risk of developing another breast cancer is higher than older women due to us getting it so young in the first place. I think some doctors tend to just be more cautious with us because of our age.

I haven't been on birth control in over 10 years, so I wasn't really concerned about going on something- the only reason it came up at all is because my periods have come back super heavy and we were discussing things that could help.. I'm hoping this will resolve itself over time.

I think ultimately this is your decision- you've heard 2 different opinions and I dont think the recommendations are as clear for those of us with TNBC.

jcatalina971

I was 41 when I was Dx TNBC stage 1. Two years later my cancer came back in lymph nodes. Stage 3C 90% ER+. It came back again a year later under my arm even on a chemo pill that treats ER+. So it's now only weakly 3% ER+. My new MO requested another block of my second cancer sent for pathology and it was only 6%ER+. So two different blocks of the same biopsy were totally different. Some people can have mixed tumors. I wouldn't recommend the birth control pills. I've just recently had another node under my arm biopsied and it was 10% ER+. I'm having two more mediastinal nodes biopsied next week and my MO wants them both sent for receptor testing. I saw one person on here that was TNBC and their MO still put them on tamoxifen. I wish my MO would have and maybe I would have stayed disease free a little longer.

123Anonymous

I too am interested in taking oral contraceptives after TNBC diagnosis. I starting taking the pill at age 17 and was diagnosed with TNBC at 30. Over the 11 years since then, I've experienced increasingly intense pain from ovarian and breast cysts. My period is so painful that it severely limits my activities. I'm sure birth control pills would help, but my gyn won't prescribe them, and I'm not on board with having an oophorectomy or hysterectomy to control pain. I've had oncologists caution against oral contraceptives in the past, but I'm wondering if there's any new research.