Cancer and contraception

Ashlesha Patel, Eleanor Schwarz

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

As a result of advances in cancer diagnosis and treatment, young women within the reproductive-aged group are now more likely to survive cancer. Reproductive-aged women with cancer may be interested in deferring pregnancy either temporarily or permanently at cancer diagnosis, during therapy or after treatment. Currently, there are limited guidelines to aide clinicians in managing the contraceptive needs in this special population. After reviewing the evidence regarding the safety and efficacy of available methods of contraception for women who have been diagnosed with cancer, the Society of Family Planning recommends that women of childbearing age who are being treated for cancer avoid combined hormonal contraceptive methods (containing estrogen and progestin) when possible because they may further increase the risk of venous thromboembolism (VTE) (Level A). The copper T380A intrauterine device, a highly effective, reversible, long-acting, hormone-free method, should be considered the first-line contraceptive option for women with a history of breast cancer (Level A), although for women being treated with tamoxifen, the levonorgestrel-containing intrauterine system (IUS) which decreases endometrial proliferation may be preferable (Level B). Women who develop anemia may benefit from use of a progestin-containing contraceptive (Level A). Women who develop osteopenia or osteoporosis following chemotherapy should avoid the progestin-only contraceptive injection (Level B). More information is needed in many areas. There are insufficient data to evaluate the risk of VTE when progestin-only contraceptives are used by women at high risk of VTE. Information is also needed on whether the levonorgestrel-containing IUS affects the risk of breast cancer recurrence and whether hormonal contraceptives affect the risk of breast cancer among women who have received chest wall, or "mantle field," radiation. Finally, studies of the safety and effectiveness of IUS use by women who are immunosuppressed and studies of whether progestin-only contraceptives affect the risk of fracture among cancer survivors or, more generally, women with osteopenia would be useful.

Original languageEnglish (US)
Pages (from-to)191-198
Number of pages8
JournalContraception
Volume86
Issue number3
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

Fingerprint

Contraception
Contraceptive Agents
Progestins
Neoplasms
Venous Thromboembolism
Levonorgestrel
Metabolic Bone Diseases
Breast Neoplasms
Copper Intrauterine Devices
Safety
Family Planning Services
Thoracic Wall
Tamoxifen
Osteoporosis
Survivors
Anemia
Estrogens
Therapeutics
Hormones
Guidelines

Keywords

  • Cancer
  • Contraception

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Cancer and contraception. / Patel, Ashlesha; Schwarz, Eleanor.

In: Contraception, Vol. 86, No. 3, 01.09.2012, p. 191-198.

Research output: Contribution to journalArticle

Patel, Ashlesha ; Schwarz, Eleanor. / Cancer and contraception. In: Contraception. 2012 ; Vol. 86, No. 3. pp. 191-198.
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