Contraception and Menstrual Suppression for Adolescent and Young Adult Oncology Patients

Zeal, Carley; Benoît, Janie; Hoefgen, Holly

doi:10.1007/978-3-030-02868-8_13

Cited by 1 publication

(1 citation statement)

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“…Hormone-dependent malignancies -Copper intrauterine system (IUS) as first line -Consider levonorgestrol IUS for patients managed with tamoxifen -Avoid exogenous estrogen and progestin 65 VTE risk secondary to estrogen or malignancy -No clear guidelines -Consider avoidance of estrogen until 6 months off treatment -Progestin only not found to increase risk 65,68,69 Anemia secondary to chemotherapy -Consider contraceptives for menstrual suppression or regulation to prevent anemia 68,69 -Refer to Table 2 for contraceptive methods [65][66][67][68][69] Bone density loss secondary to chemotherapy -Take caution with DMPA use due to bone density loss and increased risk of fracture -Limited data for patients with multiple fracture risks 65 Immunosuppression secondary to chemotherapy -Limited data on use of IUS -Safety documented in other immunocompromised groups (HIV/AIDs and solid organ transplant patients) with low infection risk of IUS 70-74 -Copper and hormonal IUS now considered categories 1-2 for immunocompromised groups aside from new insertions in complicated solid organ transplant patients (category 3) 67,65 Abbreviations: DMPA, depo medroxyprogesterone acetate; IUS, intrauterine system; VTE, venous thromboembolism.…”

Section: Patient Consideration Contraceptive Recommendationsmentioning

confidence: 99%

Female reproductive health in pediatric, adolescent, and young adult cancer survivors

Hoefgen

Benoît

Chan

et al. 2023

Pediatric Blood & Cancer

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An estimated 500,000 cancer survivors of reproductive age in the United States will live to experience the long‐term consequences of cancer treatment. Therefore, a focused aspect of cancer care has appropriately shifted to include quality of life in survivorship. Infertility is a late effect of therapy that affects 12% of female survivors of childhood cancer receiving any cancer treatment in large cohort studies and results in a 40% decreased likelihood of pregnancy in young adults of ages 18–39 years. Nonfertility gynecologic late effects such as hypoestrogenism, radiation‐induced uterine and vaginal injury, genital graft‐versus‐host disease after hematopoietic stem cell transplant, and sexual dysfunction also significantly affect quality of life in survivorship but are underdiagnosed and require consideration. Several articles in the special edition “Reproductive Health in Adolescent and Young Adult Cancer Survivorship” address infertility, genital graft‐versus‐host disease, and psychosexual functioning in survivorship. This review article focuses on other adverse gynecologic outcomes of cancer therapies including hypogonadism and hormone replacement therapy, radiation‐induced uterovaginal injury, vaccination and contraception, breast and cervical cancer screening, and pregnancy considerations in survivorship.

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