- (US) NIH
Clinical questions and recommendations
1 How is fertility assessed in cancer survivors? Does this patient need contraception?
2 How does the primary cancer type affect contraceptive options?
- Beex L.
- Rose C.
- Mouridsen H.
- et al.
- McNaught J.
- Reid R.L.
- Provencher D.M.
- et al.
- McNaught J.
- Reid R.L.
- Provencher D.M.
- et al.
3 How does the increased risk of venous thromboembolism (VTE) affect contraceptive selection?
Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case–control study.
- Lewis M.A.
- Heinemann L.A.
- MacRae K.D.
- Bruppacher R.
- Spitzer W.O.
4 How do common complications of cancer treatment impact contraceptive selection?
- Task Force for Epidemiological Research on Reproductive Health, United Nations Development Programme/United Nations Population Fund/World Health Organization/World Bank Special Programme of Research, Development and Research Training in Human Reproduction
- Gai L.
- Zhang J.
- Zhang H.
- Gai P.
- Zhou L.
- Liu Y.
- Monteiro-Dantas C.
- Espejo-Arce X.
- Lui-Filho J.F.
- Fernandes A.M.
- Monteiro I.
- Bahamondes L.
Radiation to the chest
5 Do contraceptives affect women's risk of developing cancer?
Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies.
- Kumle M.
- Weiderpass E.
- Braaten T.
- Norwegian-Swedish Women's Lifestyle and Health Cohort Study
- et al.
- Beral V.
- Doll R.
- Hermon C.
- Peto R.
- Reeves G.
Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls.
- Gadducci A.
- Biglia N.
- Cosio S.
- Sismondi P.
- Genazzani A.R.
6 Is emergency contraception safe for women with cancer?
Conclusions and recommendations
- •Combined hormonal contraceptive methods (containing estrogen and progestin) should be avoided by women with active cancer or who have been treated for cancer in the last 6 months due to the increased risk of VTE.
- •For women with a history of breast cancer, the copper T380A IUD, a highly effective, hormone-free method, is recommended.
- •For women with anemia, the levonorgestrel-containing IUS may be used to minimize menstrual blood loss.
- •For women with breast cancer treated with tamoxifen, the levonorgestrel-containing IUS provides highly effective contraception and reduces tamoxifen-induced endometrial changes without increasing the risk of breast cancer recurrence.
- •For women with a history of chest wall irradiation, systemic estrogen and progestin should be avoided.
- •Women with osteopenia or osteoporosis should avoid injectable progestin-only contraceptives.
- •Estrogen-containing contraception may be beneficial to women with osteopenia or osteoporosis.
- •Women with immunosuppression may safely use intrauterine contraception.
- •Emergency contraceptive pills may be used by women at risk of breast cancer or breast cancer recurrence who decline emergency placement of a copper T380A IUD.
Important questions to be answered
Conflict of interest
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