Reproductive Questions and Answers for Cancer Survivors: General Information

cancer-ribbonToday, more and more girls are living healthy lives after having cancer. As a cancer survivor, you may have some special concerns about your menstrual periods, fertility, and sexual relationships. This guide was created to help answer your questions about: hormones and ovaries, premature ovarian insufficiency (POI, formerly called premature ovarian failure, or POF), fertility and pregnancy, fertility treatments, other fertility issues, and sexual relationships after cancer.

What is “normal” ovarian function?

Your ovaries are a part of your reproductive system and their normal function is to release eggs and make hormones. Hormones are chemical messengers in the body that are needed for healthy growth and development in girls and women. Estrogen and progesterone are two important hormones released by the ovaries. They are the hormones responsible for healthy bones, breast growth, and regular menstruation (periods).

What is “normal” menstruation?

Menstruation, or your period, happens about once a month for most women. A typical menstrual cycle is about 28 days. This means that there should be about 28 days from the first day of your period to the first day of your next period. 28 days is an average number, but anywhere between 21 and 35 days is normal. Your period will usually last between 2-7 days. During the first year of menstruation it is common for your period to be irregular. Stress, intense physical activity, not eating well, pregnancy, and cancer treatments can all cause you to skip your period.

Will my ovaries work after receiving chemotherapy?

Both the type and amount of chemotherapy that you had could affect how well your ovaries will work. Many types have no effect on the ovaries.

During your chemotherapy, or for several months after your chemotherapy has ended, it is possible that your ovaries will temporarily stop working and then begin to work again.

Certain types of chemotherapy can also cause some women to go through menopause early and to cause periods to cease pemanently. Ask your doctor if your chemotherapy will have any effect on your ovaries. This means, instead of going through menopause at the average age of 52 years old, it’s possible that you may begin menopause early (premature ovarian insufficiency, where periods stop permanently) in your 20’s, 30’s or 40’s. This is important for you to consider when planning a family.

Will my ovaries work after having had radiation?

It depends on what part of your body was treated and the dose of radiation you were given. If you received radiation to a part(s) of your body other than your pelvis (the lower part of your abdomen, beneath the belly button), it is unlikely that your ovaries were severely affected. If your ovaries were exposed to the radiation that was used to treat your cancer, they may have been damaged.

How will I know if chemotherapy or radiation affected my ovaries?

Your oncologist or gynecologist should be able to tell you if your ovaries were affected by your cancer treatment(s). Your ovaries are part of your reproductive system. They make hormones and release eggs. Generally, if the chemotherapy and/or radiation you received affected your ovaries, your ovaries will stop making hormones and eggs and you will not have a menstrual period. The menstrual periods may stop temporarily during and after cancer treatments; it can take up to a year to know whether your ovaries have recovered somewhat from treatment and whether your period will come back.

In some cases, ovaries may be partially but permanently affected by cancer treatment(s). Some young woman may ovulate occasionally and have light or infrequent periods because their ovaries are making small amounts of hormones and some eggs. We expect that if this occurs, premature menopause is likely to occur as well.