Uterine Cancer and Your Fertility
Depending on the type of treatment you receive, uterine cancer can lead to infertility. Here's what you can do to prepare for the changes ahead.
By Jonathon Weber
Medically Reviewed by Cynthia Haines, MD
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Although uterine cancer is not commonly seen in women of child-bearing age, women who do develop uterine cancer during these years will face fertility challenges. Apart from the primary focus of uterine cancer survival, there is the lingering issue of whether or not you will be able to have children, if that was your desire.
"While uterine cancer usually occurs in women over 50 years of age, itcandevelop in women younger than 40," says Warren W. Olds, MD, a radiation oncologist at the Marshfield Clinic in Marshfield, Wis. Uterine cancer "can lead to the possibility that a woman who is of childbearing age will have her uterus removed or will undergo chemotherapy," says Dr. Olds. Infertility — being unable to conceive and bear a child — is a definite outcome of having a hysterectomy and a potential side effect of chemotherapy.
Uterine Cancer Treatment and Infertility
Infertility can result from many different uterine cancer treatments, including:
- Hysterectomy.Cancer of the uterus may make it necessary for doctors to remove the uterus, also called the womb, where the baby develops. A hysterectomy takes away all possiblity that you can become pregnant and bear a child. If you were still planning to have children when you were diagnosed, having a frank discussion with your health care team about whether a hysterectomy is critical in your uterine cancer treatment plan should be on the agenda as early as possible.
- Chemotherapy.Chemotherapy can damage a woman's eggs or other parts of the female reproductive system and cause difficulty conceiving or carrying a baby to delivery. However, there is still a possibility that a woman may become pregnant after having treatment. In fact, there have been successful pregnancies after chemotherapy using fertility treatments.
- Radiation therapy.This treatment option can also cause reproductive damage. While radiation therapy can sometimes be tailored in ways that are more protective of the reproductive organs, in the case of uterine cancer this may be difficult.
If preserving your fertility is a goal, talking with your doctor about how to choose the best treatment plan is important. Together, you can go over the pros and cons of the various options. A more conservative approach using hormones, rather than chemotherapy or radiation, to fight the cancer may be an option for women concerned about fertility. One recent study of 133 women diagnosed with uterine cancer at age 45 or younger determined that hormonal therapy for an average duration of six months led to successful cure of the disease in 66 percent of the women.
Uterine Cancer Treatment and Other Sexual Changes
In addition to problems with infertility, uterine cancer treatment can also lead to vaginal dryness or narrowing. "Women who develop uterine cancer can have vaginal changes, which may include shortening, narrowing, and decreased lubrication of the vaginal area," says Jonathan S. Berek, MD, an obstetrician and gynecologist who specializes in uterine cancer at the Stanford University School of Medicine in California. As a result, a woman can experience problems with intimacy because of pain or decreased sexual desire.
Solutions like vaginal moisturizers or lubricants used during intercourse help relieve some of the pain. Also, vaginal dilators and sexual intercourse itself can help prevent narrowing of the vagina during and after chemotherapy.
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