Menstrual Delay After Breast Cancer Treatment and Tamoxifen Use

Q: Menstrual Delay After Breast Cancer Treatment and Tamoxifen Use

Hello Miss Anan： There is no need to worry about the effects of inducing menstruation on your current condition or the medications you are taking. <br>If you are taking tamoxifen, it is important to have regular checks of the endometrial thickness, as long-term use of this medica

Menstrual delay

Hello Dr.
Huang,
I have a question to ask.
In May of this year, I was diagnosed with left ductal carcinoma in situ, and subsequently underwent a partial mastectomy, radiation therapy, and have been continuously taking Tamoxifen since then.
Initially, I noticed that my menstrual flow decreased by about half, but after my period ended on July 25, it has been delayed until now.
I consulted with a gynecologist who was informed about my current medication.
The doctor performed an ultrasound to check the thickness of my endometrium and conducted a pregnancy test, indicating that the endometrial thickness is acceptable and that I am not pregnant.
The doctor suggested that this delay might be a side effect of Tamoxifen.
If my period does not return in two weeks, I may need to receive a medication to induce menstruation, either via injection or orally.

I would like to ask Dr.
Huang if using a medication to induce menstruation, whether by injection or orally, would have any impact on my current condition and the medication I am taking (Tamoxifen).
Thank you.

An An, 40~49 year old female. Ask Date: 2016/09/20

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello Miss Anan: There is no need to worry about the effects of inducing menstruation on your current condition or the medications you are taking.
If you are taking tamoxifen, it is important to have regular checks of the endometrial thickness, as long-term use of this medication can increase the risk of endometrial hyperplasia.

Reply Date: 2016/09/20

More Info

Understanding the relationship between menstrual delay and Tamoxifen use after breast cancer treatment is crucial for patients navigating their recovery. Tamoxifen is a selective estrogen receptor modulator (SERM) commonly prescribed for hormone receptor-positive breast cancer, particularly in cases like ductal carcinoma in situ (DCIS) or early-stage invasive breast cancer. Its primary purpose is to block estrogen from binding to its receptors on breast cancer cells, thereby inhibiting their growth and reducing the risk of recurrence.

In your case, experiencing a reduction in menstrual flow followed by a delay in menstruation after starting Tamoxifen is not uncommon. Tamoxifen can influence the menstrual cycle due to its action on estrogen receptors, which can lead to changes in menstrual patterns. While some women may experience lighter periods or amenorrhea (absence of menstruation), others may have no significant changes. The hormonal changes induced by Tamoxifen can lead to variations in the menstrual cycle, and these effects are often temporary.

Regarding your concerns about the potential need for menstrual induction through medication, it is essential to understand that using medications like progestins to induce menstruation is generally safe for women taking Tamoxifen, especially if there are no contraindications. However, it is crucial to have a thorough discussion with your healthcare provider before proceeding with any hormonal treatment. They will consider your overall health, the specifics of your breast cancer treatment, and any potential risks associated with inducing menstruation.

It's also important to note that while Tamoxifen is effective in reducing the risk of breast cancer recurrence, it can have side effects, including hot flashes, vaginal discharge, and changes in menstrual patterns. Regular monitoring of your health, including gynecological evaluations, is recommended while on Tamoxifen. Your healthcare provider may suggest periodic ultrasounds to assess the thickness of the endometrium, as prolonged use of Tamoxifen can increase the risk of endometrial hyperplasia or cancer.

In summary, the menstrual changes you are experiencing could be attributed to Tamoxifen, and it is advisable to communicate openly with your healthcare team about your symptoms. If menstrual induction is deemed necessary, your doctor will guide you on the safest and most effective approach. Always prioritize regular follow-ups and screenings as part of your ongoing care after breast cancer treatment.

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