When or If Your Periods Return

Some very young women never lose their periods during, or after, breast cancer chemotherapy. Many are able to become pregnant and deliver a healthy child.

Most women in their 30s get their periods back after a pause in their menstrual cycles. That pause may last three to six months—or maybe longer. However, even if your periods return, you may have fewer eggs in your ovaries available to be fertilized.

This means you'll continue to have your periods over time, but will probably go into menopause earlier than you would have without having gone through cancer treatment. For example, if most women in your family went through menopause at age 50, you might go through menopause at age 45, or younger.

For these reasons, all women in their 30s should talk to their doctors about fertility issues before beginning cancer treatment. Younger women may be able to conceive a child on their own after cancer treatment, but they are likely to have more difficulty than other women of their age getting pregnant as they get older.

Some women may have trouble becoming pregnant later on because of non-cancer-related fertility problems. You may be infertile after chemotherapy and pursue fertility treatment, but your implanted embryos may not result in a successful pregnancy. In this case, you can still consider becoming pregnant through egg donation.

For many women, adoption is another attainable alternative.

RESOLVE is an organization devoted to providing education and support to individuals with fertility problems. RESOLVE is headquartered in Bethesda, Maryland, with a nationwide newtwork of chapters. For information, go to www.resolve.org or call 301-652-8585.

How long do you wait to get pregnant?

Many doctors recommend a wait of at least 2 years to get you past the time when the risk of cancer recurrence is highest and your health is back in full strength. However, for women who were treated for early breast cancer, research indicates that waiting only 6 months appeared to cause no significant increase in cancer recurrence or pregnancy risks. It's unclear when to start that countdown—from the time of diagnosis, or from when treatment ends. Remember that your risk of cancer recurrence depends upon your unique situation.

To avoid getting pregnant, use barrier methods of birth control: condoms or a diaphragm. DON'T use birth control pills after treatment for breast cancer. Birth control pills contain estrogen. It's unclear if birth control pills are safe for women with a personal history of breast cancer to take, so doctors don't recommend it.

Two years is a long time to wait, especially if you're already in your mid-30s or older. Even if your periods have returned, your chances of becoming pregnant may not be as high as they would have been without breast cancer treatment.

If you received chemotherapy and would like to get pregnant, you should see a fertility specialist. This is because your menstrual cycles might not continue for as long as they might have without chemotherapy. Every woman becomes less fertile as she ages. And treatment may further reduce the functional life of your ovaries.