Chemotherapy and hormone therapy used in the treatment of breast cancer can affect the menstrual cycle, fertility, and also cause other problems associated with gynecological health of premenopausal women. Tamoxifen - one of the main drugs hormone therapy, which is used as adjuvant therapy and in metastatic cancer in this category of patients.
Young women with a breast tumor are often concerned about issues related to their gynecological health, in particular, how tamoxifen and monthly cycles interact, how the purpose of this drug affects reproductive function, the onset of menopause. To begin with, it is necessary to understand the principle of its operation.
Indications for use and reception characteristics
Tamoxifen( Nolvadex®) is a tablet preparation that is more than 30 years oldUsed for hormonal therapy for breast cancer in both women and men. It is included in the group of so-called selective estrogen receptor modulators, "works" in the breast tissue as an anti-estrogen( antagonist): it attaches itself to the receptor of this hormone and thus prevents it from realizing its activity.
The blocking of estrogen receptor( ER) stops the growth of cancer cells. But in other organs( eg, the uterus), tamoxifen may act as an ER agonist. That is, to possess estrogen-like properties, for example, to stimulate the proliferation of the endometrium, to cause the growth and development of follicles in the ovary. Therefore, irregular monthly with the administration of tamoxifen - a common phenomenon.
Tamoxifen is used in the following situations:
- To reduce the likelihood of breast cancer. For this purpose, the drug is recommended for women who have a high risk of neoplasm.
- As adjuvant( preventive) therapy of breast cancer. That is, in women who have completed treatment( surgery, radiation and chemotherapy), tamoxifen is used to prevent the appearance of metastases and a new tumor.
- To reduce the likelihood of developing invasive breast cancer in women who have received treatment for ductal carcinoma "in situ"( DCIS).
- For the treatment of metastatic breast cancer in both women and men.
Tamoxifen is available in tablet form( oral administration only, ie through the mouth).
Useful video
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Contraindications to
This medicine is strictly prohibited to use:
- during pregnancy if a woman is only planning to become pregnant, as the drug can harm a future child( in order to be sure thatpregnancy is not, you should start taking tamoxifen after the onset of menstruation or take a test);
- during lactation;
- if there was an allergic reaction to this medication.
In case a woman takes tamoxifen, and a delay in menstruation occurred against this background, stop taking the medication immediately and consult a doctor. Although the drug itself causes a violation of the menstrual cycle, nevertheless, it can be pregnancy. Therefore, in any case, you need to consult a doctor.
If a woman plans to take tamoxifen to reduce the risk of breast cancer, then its use is not recommended in the following situations:
- in the past was a "kurtosis excess", which required treatment( thrombosis of deep veins, etc.);
- a woman takes anticoagulants( eg, warfarin);
- long stay in an immobilized state( treatment after fractures and so on);
- various forms of thrombophilia( increased risk of blood clots).
Effect of tamoxifen on the uterus( endometrium)
In postmenopausal women, tamoxifen has the property of an estrogen agonist and can stimulate endometrial proliferation, which leads to atypical hyperplasia and the development of uterine cancer. Nevertheless, the drug in premenopausal women has an effect on the endometrium as an antiestrogen.
It is proved that in this category of women it does not increase the risk of developing polyps, hyperplasia or uterine cancer.
Should I continue to drink tamoxifen if my menstrual period begins? In premenopausal women, this drug acts on the ovaries like estrogen, it to some extent participates in the recovery of the menstrual cycle in women who received chemotherapy, and the endometrium does not have any harmful effects. Therefore, there is no need to worry about the resumption of the menstrual cycle of this category of women.
Tamoxifen and Fertility
One of the problems for young patients treated for breast cancer is the loss of reproductive function. Many women who at the time of treatment were under 40 years old, want to quit menopause, plan to become mothers. Conducted chemotherapy and hormone therapy have a detrimental effect on fertility, in addition, they approximate the timing of natural menopause. However, some women recover from a regular period after tamoxifen withdrawal, and they can become pregnant.
Modern medicine offers several ways to preserve the genital function of a woman with breast cancer. One of them is the storage of embryos during the period of therapy, which involves taking the egg, fertilizing it and freezing it. This procedure has a high probability of successful implantation of the embryo into the uterus. Another technique with lower chances of success is the storage of unfertilized eggs.
It also uses techniques to prevent the "pernicious" effect of chemotherapy on the ovaries. Synthetic gonadotropin-releasing hormone analogues such as leuprolide( Lupron), goserelin( Zoladex), are able to protect the ovaries during chemotherapy, which prevents early menopause, accelerates the recovery of the menstrual cycle.
We recommend reading the article on chest pain after menstruation. From it you will learn about the possible causes of pain in the mammary gland, a survey and the need to consult a doctor. If a woman wants to maintain her fertility after treatment of breast cancer - this issue should be discussed with the doctor. To solve this problem, as a rule, not only the participation of an oncologist, but also a gynecologist, and a highly specialized doctor - reproductologist is required.