Contraception and Breast Cancer
Cancer treatments like chemotherapy and endocrine therapy (such as tamoxifen) can affect your fertility, but they don’t always eliminate your ability to become pregnant. If pregnancy is not your goal during this time, it’s important to use birth control when having sex that could lead to pregnancy. Some treatments can cause temporary or permanent changes to your menstrual cycle—even stopping periods entirely (a condition called amenorrhea)—but that doesn’t always mean you can’t conceive.
Contraception can help you avoid an unplanned pregnancy, especially since some medications may increase the chance of miscarriage or birth defects if used during early pregnancy. After treatment, you may still need contraception depending on your preferences and plans for the future. Condoms are also recommended to protect against sexually transmitted infections (STIs), regardless of your contraceptive method.
Choosing Contraception
While undergoing treatment for breast cancer and if could become pregnant, it’s important to know that many therapies—including chemotherapy and hormone-based treatments like tamoxifen—can harm a developing fetus. Even if your periods have stopped or become irregular, pregnancy is still possible unless your fertility has been permanently affected.
Non-hormonal methods are recommended because hormonal contraceptives can increase the chance of breast cancer recurrence, especially for people with hormone receptor-positive disease.. Always talk to your oncologist or care team before starting or continuing any form of birth control.
Contraceptive Options Often Considered Safe Include:
Cervical Cap
A reusable silicone cup inserted to fit snugly over the cervix, blocking sperm from entering the uterus and typically used with spermicide for contraception.
Condoms (with or without spermicide)
A thin barrier worn over the penis or placed inside the vagina during sex to prevent sperm from entering the body, helping protect against pregnancy and sexually transmitted infections.
Copper IUD (non-hormonal intrauterine device)
A T-shaped device placed in the uterus that releases copper to create an environment that prevents sperm from fertilizing an egg, providing long-term, hormone-free contraception.
Diaphragm
A flexible dome-shaped device inserted before sex to cover the cervix and prevent sperm from reaching an egg, typically used with spermicide for contraception.
Sponge
A soft, disposable foam device inserted before sex that covers the cervix and releases spermicide to help prevent pregnancy.
Tubal ligation or vasectomy
For those certain they do not wish to have biological children in the future: a permanent surgical procedures that prevents pregnancy by blocking or cutting the fallopian tubes or the vas deferens to stop sperm from reaching an egg.
In some cases, a progestin-releasing IUD may be considered. This decision should be made in consultation with your oncologist, based on your cancer type and overall treatment plan.
What About Hormonal Birth Control?
Hormonal contraceptives, such as pills, patches, injections, or hormone-releasing IUDs, contain estrogen and/or progestin, which may stimulate cancer growth. Because of this, most oncologists recommend avoiding these methods if you have hormone receptor–positive breast cancer.
For people with hormone receptor–negative or non-invasive breast cancer, hormonal methods may be considered, but only after a detailed discussion of the risks and benefits with your care team. Every decision should be individualized to your diagnosis, treatment plan, and personal goals.
Talking With Your Partner
Changes in sexual health and contraception can affect your relationship, especially during the stress of treatment. Honest communication can help you both feel more connected and supported.
- Choose a quiet, relaxed time to talk.
- Focus on how you’re feeling, physically and emotionally.
- Share concerns and hopes without judgment.
Remember: intimacy can be expressed in many ways. Go at a pace that feels right for you both.
Opening the conversation might feel difficult—but addressing the “elephant in the room” can deepen your emotional bond and improve your shared experience.
