What You Can Do

• Ask your doctor if the chemotherapy will likely affect your ability to father a child. If so, ask if the effects be temporary or permanent.
• Before starting treatment, talk to your doctor about the possibility of sperm banking if infertility may be a problem. Banking is a procedure that freezes sperm for future use.
• Use birth control with your partner during treatment. Ask your doctor how long you need to use birth control.
• Ask if you should use a condom during sexual intercourse after chemotherapy, since some of the chemotherapy may end up in the sperm.

Effects on the Ovaries

Anticancer drugs can affect the ovaries and reduce the amount of hormones they produce. Some women find that their menstrual periods become irregular or stop completely while having chemotherapy. Related side effects may be temporary or permanent.

• Infertility —Damage to the ovaries may result in infertility, the inability to become pregnant. The infertility can be either temporary or permanent. Women of child-bearing potential who wish to preserve their ability to become pregnant have an option of embryo cryopreservation. A referral to a fertility expert will be needed in such situations.
• Ovarian failure —A woman's age and the drugs and dosages used will determine whether she experiences an ovarian failure while on chemotherapy. Chemotherapy-induced amenorrhea (absence of menstruation) is a well-recognized side effect of chemotherapy. Some women develop complete and permanent ovarian failure (menopause) during chemotherapy. Other women may stop menstruating during therapy, but then later (months to years) the ovarian function, menstrual cycles, and fertility may return. Chemotherapy may also cause menopause-like symptoms such as hot flashes and dry vaginal tissues. These tissue changes can make intercourse uncomfortable and can make a woman more prone to bladder and/or vaginal infections. Any infection should be treated right away.

Help for Hot Flashes

These tips may help:

• Dress in layers—to help you remain comfortable and avoid feeling overheated
• Exercise—to increase energy level, reduce the risk of depression, and improve bone health
• Try meditation or other relaxation methods—to improve sleep quality, reduce stress, and enhance your overall mood

Relieving Vaginal Symptoms and Preventing Infection

These tips may help:

• Use a water-based vaginal lubricant at the time of intercourse.
• There are products that can be used to stop vaginal dryness. Ask your doctor about vaginal gels that can be applied to the vagina.
• Avoid using petroleum jelly, which is difficult for the body to get rid of. It also increases the risk of a yeast infection.
• Wear cotton underwear and pantyhose with a ventilated cotton lining.
• Avoid wearing tight pants or shorts.
• Ask your doctor about prescribing a vaginal cream or suppository to reduce the chances of infection.

Pregnancy

Although pregnancy may be possible during chemotherapy, it usually not advisable because some anticancer drugs may cause birth defects. Doctors advise women of childbearing age, from the teens through the end of menopause, to use some method of birth control throughout their treatment, such as condoms, spermicidal agents, diaphragms, or birth control pills. Birth control pills may not be appropriate for some women, such as those with breast cancer. Ask your doctor about these contraceptive options.

If a woman is pregnant when her cancer is discovered, it may be possible to delay chemotherapy until after the baby is born. For a woman who needs treatment sooner, the possible effects of chemotherapy on the fetus need to be evaluated.