Because of the way doxorubicin is usually given, this is not a danger, assuming one starts with a healthy heart. If there is any question about a woman's heart health, she may need a special heart test before getting doxorubicin. The heart test is not painful or dangerous. If her heart is not healthy, doxorubicin will not be recommended. The only common permanent side effect of adjuvant chemotherapy is early menopause.
Chemotherapy commonly causes the menstrual cycles to become irregular or cease.
This effect may be temporary, but is often permanent. Women younger than 40 usually do not go through menopause as a result of the chemotherapy, but a few do. Women older than 40 usually do go through menopause as a result of the chemotherapy. Contraconception during chemotherapy is important because it can cause birth defects if given during the first trimester of development. Women who maintain their fertility after chemotherapy have the same chance of having a healthy child as anyone else.