Forum Discussion

Skbr's avatar
Skbr
Member
4 years ago

Hormone Therapy advice for young women who want to have children

Hi everyone 😊  I’m seeking some advice on what hormone therapy is best for younger women who want kids in the future. 

I have Grade 1 multifocal IDC+DCIS, 80% hormone positive, ER- cancer & I’m premenopausal, with no children. I was told after 2 years of hormone therapy I can try to fall pregnant (…but am hoping 1.5 will be enough?) 

I have been given three options for hormone therapy:

•Tamoxifen only
•Zoladex + Tamoxifen 
•Zoladex + Exemestane (Aromasin)

All offer similar coverage in regards to my type of cancer, but I was wondering if there are any differences in regards to future fertility? 

ie. longer detox periods required before falling pregnant, or potential fertility issues after long term use, eg Zoladex or Exemestane? 

I have also read that Exemestane (Aromasin) is an *irreversible* steroidal aromatase inhibitor. I don’t want to be on anything that could irreversibly damage my oestrogen production.. Fertility-wise, does anyone know if this is something to avoid until after having children?

I’d really appreciate any advice & tips for having the best chance of getting pregnant in 2 years! X
children
hormone-therapy
letrozole
tamoxifen
young-women
  • JaneinMelbourne's avatar
    JaneinMelbourne
    Member
    4 years ago
    Yes I paid for the Prosigna test. Based on my cancer the risk of recurrence isn’t higher in year 1 versus year 3 for example - just each year it reduces down by 0.5%, so actually it is not super risky only waiting the one year in my instance versus 2. 
    I’ve also had radiation and chemo. 

    That’s interesting re the tamoxifen study, I will have been on it for approx 5 months before coming off and my doctors haven’t raised that as an issue so will follow their advice for now! 

    Good luck with it all xx
  • Skbr's avatar
    Skbr
    Member
    4 years ago
    Hi @JaneinMelbourne, thank you so much for your response. Could I ask how you know your risk of recurrence is 0.5%? Is there a test? or did your oncologist work it out? 

    I’m finding it difficult to get any specific information like that from my oncologist. It’s all very vague.

    She ideally wants me to be on “Zoladex & an Aromatase Inhibitor”, but could also try “Zoladex & Tamoxifen”

    The “Zoladex and AI” is the most effective at stopping any recurrence. But from what I understand I’m low risk, like yourself (I had clear lymph nodes & I didn’t need chemo or radiation), so I don’t know why she wants to put me on the strongest combination, for 2 years.. it’s interesting to hear that 1year could be ok too.

    There is also a new study indicating that Tamoxifen needs a 9month detox/washout period before falling pregnant.. So that is adding another layer of confusion to the decision! 
  • JaneinMelbourne's avatar
    JaneinMelbourne
    Member
    4 years ago
    Hi @skbr 

    Similar situation for me, I’m hoping to start IVF one year after my initial diagnosis. My oncologist recommended I switch to tamoxifen - knowing that it would take some time for my ovarian function to return and allowing this to occur versus shutting this down completely. My risk of recurrence is 0.5% each year - so this has been factored in to that decision. 

    Hope that helps! I was upset at 2 years so know that feeling. I’ll come off for 8 weeks prior to starting IVF, pending my imaging coming back all clear xx


  • Skbr's avatar
    Skbr
    Member
    4 years ago
    Hi @brightspace. Thank you very much for your suggestion. I’m not sure what you mean by page 4 MIA? Is that page 4 of the “Tests, Treatments and side effects” discussion forum? 
  • brightspace's avatar
    brightspace
    Member
    4 years ago
    Hi Skbr
    some info has been posted recently
    See page 4 MIA
    Very informative for your situation