The risk of premature menopause with chemotherapy has a lot of implications for survivors. They get a lot of symptoms and they have longer-term risks for things like osteoporosis. Adjuvant chemotherapy can lead to a temporary or permanent end to a women's menstrual cycle by damaging the ovaries. While this side effect is less common in younger women, it is common in women over 40. On the flipside, women who continue to menstruate after chemotherapy are at greater risk of premature menopause.
Many women diagnosed with breast cancer are still in their childbearing years.
Questions arise concerning the ability to get pregnant, the effects of chemotherapy on future fertility or what effect will breast-conserving surgery have on the ability to produce milk. Clinicians are urged to work closely with their patients on issues such as childbearing. Some rules of thumb, such as standard advise not to become pregnant for two years after treatment, may not hold for older women who want to become pregnant after treatment. Women taking tamoxifen who wish to become pregnant should discontinue tamoxifen use several months before conceiving. While the drug's effect on human fetal development is not known, it has been shown to cause urogenital abnormalities in lab rats.