Chemopause and birth control

nash · January 2008

I'm sure this has been discussed a lot before, but I'm too chemo brained out to do a thorough archive search. So, what's the deal with birth control and this weird no-period/hot flashes la-la land I'm in from the chemo? I know that it's advised to use birth control while on tamoxifen (which I'll start after rads), but that's confusing, too, as the onc said tamoxifen shuts the ovaries down.

So...if there are no periods and lots of hot flashes from the chemo, how can I be ovulating? If tamoxifen shuts the ovaries down, why use birth control?

I supposed it's all just to be safe, but frankly, I'm really grumpy about not being able to be on the pill anymore. There was a reason I took it for almost 18 years! Oh--and my onc has said not once, but three times, that the pill contributed to my bc. If she says it a fourth time, I may just smack her.

BethNY · January 2008

You can't take birth control after getting breast cancer.

While on Tamoxifen you need to use birth control-- like condoms, b/c you're not supposed to get preggers while on tamox-- bad for fetus.

Cynthia1962 · January 2008

Chemopause can end at any time and you can be fertile without knowing it, so it's best to just consider yourself fertile. It's even not unheard of for menstrual cycles to resume a year or two after they stopped due to chemo. As for Tamoxifen, it does NOT shut the ovaries down! It can make your cycles irregular, but it was once used as a fertility treatment so you definitely will need birth control while on it until your hormone levels indicate you're post menopausal.

There's a Tamoxifen thread under the Hormone Topic where we discuss all things Tamoxifen. Feel free to join us.

Cynthia

nash · January 2008

Thanks, girls. I know I can't take the pill b/c I'm ER/PR+. Really detest all other bc methods--that's why I'm so annoyed! Undecided

I had wondered about the "tamox shuts the ovaries down" comment from the onc, Cynthia. She told me that I absolutely should not be bleeding at all on tamox, and that if I did, I should have an endometrial biopsy. I did do some reading over on the HT boards, and it seems that periods do stop on tamox, and others were advised the same on endo biopsies. But she was adament that the ovaries are shut down by the tamox. But you're right--I'd totally forgotten that tamox has been used as a fertility treatment.

She also told me that my chemopause was permanent b/c I'm 39. I had questioned that, too. It's starting to sound like this onc was off the mark.

Cynthia1962 · January 2008

Both my med onc and rad onc told me that at my age (45), my cycles may or may not return. The younger a woman is when she goes through chemopause, the more likely her cycle is to return. There are a lot of women on Tamoxifen who are still menstruating. My gyn says that if I experience bleeding, I need to have a bx to rule out non-menstrual bleeding caused by the Tamoxifen. If the bx is normal, and the bleeding establishes a pattern than I can assume my cycles have returned and not worry about it. Tamoxifen over stimulates the ovaries which may cause them to become dysfunctional, but the affect is only temporary unless I go through menopause in the meantime, I guess. Oh, well, I'll enjoy it while I can. lol

Here is some info I read about Tamoxifen:

Fertility: Tamoxifen may cause disturbances of menstrual cycle, including infrequent or light menstruation and amenorrhea. Tamoxifen does not induce menopause. Premenopausal women should be advised not to become pregnant while taking tamoxifen. Tamoxifen has been used to treat infertility.

The results of this study are interesting, too:

http://www.cancer.gov/clinicaltrials/results/menstruation0206

Good luck and I hope you find some of this helpful. Wish I had some advice to offer about bc, but there just aren't a lot of options out there, especially for us ER+ women.

Cynthia

BethNY · January 2008

nash periods should not stop on Tamox... I can'tbelieve your doc is telling you that.

It works like a lock and key and binds the estrogen so it doesn't fuel cancer cells.

Get used to condoms. The sooner you start using them, the better it will be. And get some lube too, cause most guys hate condoms, and it's hard to stay erect in them sometimes. But thats your choice. My ONC is against the IUD, b/c many of them have hormones in them, and she says they promote bleeding, and it would be hard to tell if it was uterine cancer...

once you get on board with the condom thing, it won't be as bad as you think...

nash · January 2008

Thanks again, girls. Wow--I'm glad I'm checking in with you guys on the periods. This was a gynecological onc at a university hospital who was telling me all this stuff. Yipes.

Yeah, condoms it will be. Although my husband did bring up a vasectomy (obviously he hates condoms, too!), so maybe that's a better solution. We already have two kids. Can't see having a third one at this point.

Myrajuc · January 2008

I was 37 when diagnosed September 06. It's just a little over a year. After chemo in March, my period started coming back like 4 months after. Now regularly, every month, on the dot, and heavy. I was on the pill for 16 years, no periods for the last 10 years and I loved it. And I hate condoms. But we don't have a choice.

I had neoadjuvant chemo and adjuvant, 3 weeks AC, 12 weeks Taxol/Herceptin, and still on Herceptin for a year. I had menopause, no periods which was good, but the hot flashes were an experience, it was weird. I didn't take meds for it, just sweated it. I wore scarves most of the time during chemo and bald days.

Email me if you have questions.

Take care,

Myra

mjucutan@yahoo.com

judy225 · January 2008

Hi ladies

Was wondering how femara effects the chemopause and birth control at 40? I haven't had period since 03/07, test on 12/07 show in menopause. what is likely hood of getting period back at this time?

mplscello · January 2008

Hi Judy,

I was in chemopause at age 35, was on tamoxifen for a few years and then aromasin for a year, then went back on tamoxifen after having a period -- first one in about 5 years -- then became pregnant for the first time last year at age 40! I was sure it was impossible (long story, they thought I might be bleeding because of a uterine polyp and the FSH test was borderline) but there it was. I was not using birth control at the time.

There was some concern because I was on tamoxifen when I got pregnant, but everything turned out fine. Beautiful healthy baby girl on 7/7/07! Now I'm back on tamoxifen for a year, no periods yet, still in denial about using condoms but I guess we'd better do it! Either that or vasectomy (my vote). My hot flashes haven't returned so I'm using that as my menopause barometer.

take care,

LeeAnn

judy225 · January 2008

HI LeeAnn

wow, what a blessing, to receive wonderful little baby girl. Seems sometimes things really do work out for a reason! Enjoy your bundle of joy! And congrats for making that 6+ year mark.

So if period can come back 5 years later, then guess need another form of bc - what?? condoms only work so long, vasectomy, remove ovaries, what are other choice??

judy

Raye99 · January 2008

Judy, I asked my onc the same thing - I was 39 and she explained I might not get my periods back, but she didn't know for sure. Six months after chemo, they came back with a vengence. Like Myra's, they're heavy, crampy periods every 21 days to the day - like I am 13 again! I had been on the pill for a long time and was so used to 2-day light periods. NO PILL and I am triple neg, not that I would take it even if allowed. My husband had a vasectomy, so we are OK in that regard.

LeeAnn, congrats on your little beauty girl!

Raye

Chemopause and birth control

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