Elephants and Tea - September 2019 - 17

INTIMATE ISSUES WITH MARLOE

WARNING
MATURE
C ON T E N T

ince cancer, I've been trying to be better about
living in the moment. You know - seizing the day,
taking more chances, throwing caution to the wind...
But there are still a few situations in which preparation
and planning should be the golden rule, and one of them
is contraception. Making smart, thoughtful choices about birth control is
an important part of taking responsibility for your sexual health, regardless of cancer status.
Studies show that during and after treatment for cancer, we young
survivors consistently underestimate our ability to get pregnant or
cause pregnancy for our partners. We are also less likely than our cancer-free peers to use highly effective birth control methods. And this
isn't without consequences; cancer survivors are three times more likely
to experience an unintended pregnancy than the general population.

WAIT, I THOUGHT CANCER TREATMENT
CAUSES INFERTILITY?
So...it's complicated. During or after certain treatments for cancer, your
fertility may be reduced temporarily or permanently, or you may experience
complete infertility temporarily or permanently, or your ability to have
children may not be compromised at all at any point in your treatment.
What gives?
The degree to which your fertility is impaired, and for how long, is individualized and
depends on a number of things. Factors like
your age, the type of cancer you have, and the
specific type, dosing and number of treatments
can all play a role. Also, the negative effects of
radiation or chemo on fertility often happen
gradually, which means that pregnancy could
happen during active treatment. An exception,
of course, would be if you had both of your
ovaries or your uterus removed surgically, or
both testicles. These types of surgeries cause
immediate and permanent infertility.
HOW WILL I KNOW IF I NEED TO USE BIRTH CONTROL?
It's not always easy to tell if you can get pregnant or get your sexual partner
pregnant. Both men and women can potentially maintain or regain their
ability to have children after going through cancer treatments. For some
women, pregnancy is still possible even if they aren't getting a period or if
their periods are irregular. Talking with your provider can help you better
understand your need for contraception.
WHAT IF MY PARTNER AND I WANT TO
BECOME PREGNANT?
It is important to avoid pregnancy while undergoing cancer treatments
and for a certain time after. Both radiation therapy and certain anticancer
medicines can adversely affect a developing embryo or fetus, and becoming pregnant at this time may require you to make a decision between the
most effective treatment for your cancer or compromising the health of
your pregnancy.
Some women are diagnosed with cancer when they are already
pregnant. In this case, a woman's healthcare team will help her make

Sexuality

an informed decision about treatment. Certain treatments are
safe during pregnancy, especially in the second or third trimester.
Chemotherapy or radiation can also damage the DNA in egg or
sperm cells, which may increase the risk for birth defects or miscarriage
temporarily. However, it is worth noting that overall, studies have not
shown an increased incidence of birth defects in children conceived
by survivors after treatment for cancer.
If you wish to have children after treatment, ask your provider how
long you should wait before attempting to conceive. Your provider may
recommend waiting anywhere from six months to three years after
the end of your treatments. During this time, use an effective birth
control method.
WHAT BIRTH CONTROL OPTIONS ARE
AVAILABLE FOR CANCER SURVIVORS?
Your medical history, the type of cancer you have, and your treatment plan
may affect what birth control options are available to you. Other important
considerations include whether the method is reversible or permanent,
long-acting (which is typically more effective) or short-acting, how easy it
is to acquire and to use and whether it provides protection against sexually transmitted infections (STIs). Some methods require a prescription
or a clinic appointment to access, while others
are available over-the-counter. Ideally, you will
work with your provider to find a method that
is safe for your circumstances, highly effective
and easy to use.
The National Comprehensive Cancer Network (NCCN) recommends long acting, reversible contraceptives for women with a history
of cancer (as long as there are no contraindications) because they are the most effective at
preventing pregnancy. The only non-permanent
option available for men is the male condom,
a barrier method that is effective when used
correctly and with every sexual encounter.
Combining the use of two compatible methods at the same time (such
as pairing condoms with another type of birth control, for example)
is called the "dual method" approach. This is a good way to increase
protection against pregnancy. It's also a good idea to talk with your
partner about your plan birth control before you're in the heat of the
moment to make sure you're both on the same page.
Barrier Methods
Barrier methods work by preventing sperm from fertilizing an egg. These
include the female and male condoms, as well as the diaphragm, cervical
cap, cervical sponge and spermicides. The effectiveness of each depends on
how consistently and accurately the method is used. You can easily pair a
barrier method with the use of hormonal birth control or an IUD for extra
protection. Condoms are the only method available that also help protect
against transmitting STIs.
Hormonal Methods
Hormonal methods prevent pregnancy by stopping ovulation, changing
cervical mucous characteristics and altering the uterine lining.

STOP AND TALK TO YOUR PROVIDER ABOUT SEXUAL HEALTH IF YOU HAVE QUESTIONS

ELEPHANTSANDTEA.COM
SEPTEMBER 2019

http://www.elephantsandtea.com

Elephants and Tea - September 2019

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