Do I need to take birth control after chemotherapy?
At the time you started chemotherapy, were you definitely in menopause? (Menopause is defined as not having a natural period for at least 12 months.)
After you finished chemotherapy, have you had any vaginal bleeding?
How old were you when you started chemotherapy?
How many years has it been since your last period?
Not needed
You do not need birth control to prevent pregnancy.
Discuss with your healthcare provider
If you are not sure if you were menopausal at the time of chemotherapy, please discuss with your health care provider.
You may still be at risk for pregnancy.
If you do not want to get pregnant, we advise you use a birth control method. Talk to your health care provider about the best birth control options for you.
You may still be at risk for pregnancy until age 45.
If you do not want to get pregnant, we advise you use a birth control method until you are at least 45 years old. Talk to your health care provider about the best birth control options for you.
Your chance of getting pregnant is very low to zero.
It is reasonable to stop using birth control at this time.
Birth control is generally not recommended
These medications make pregnancy very unlikely, so birth control is generally not recommended.
Disclaimer: Always talk with your healthcare provider and know that each person is unique in their contraceptive choices.
Does My Breast Cancer Type and Hormone Status Matter?
Understanding Birth Control Effectiveness
One of the most common questions people ask about birth control is:
“How well does this method actually work?”
The answer depends on the method and how you use it.
What is a failure rate?
Your healthcare team may talk about something called the failure rate, which is just another way of saying:
“Out of 100 people using this method for one year, how many are likely to get pregnant?”
Perfect Use vs. Typical Use
Every method has two effectiveness numbers:
Perfect use: When the method is used exactly right every single time
Typical use: How most people use a method in real life (missing pills, forgetting condoms, not using something every time, etc.)
Because real life isn’t perfect, typical use is usually less effective than perfect use.
Example: A birth control method where the penis is pulled out of the vagina before ejaculation. Also called "pulling out." It is less effective than other methods but hormone-free. (“pulling out”)
Typical use: About 20 out of 100 people will get pregnant in a year
Perfect use: About 4 out of 100 people will get pregnant in a year
The difference shows how much everyday habits can affect effectiveness.
Comparing Methods to Using No Birth Control
It can be helpful to compare these numbers to not using any birth control at all.
Without any method, about 85 out of 100 people (85%) will get pregnant within one year.
Important note: This 85% number is based on studies of the general population, which often includes younger people with higher fertility.
For people who have had breast cancer, fertility may be lower because of age, treatments like chemotherapy, or other health factors. Still, pregnancy is possible, so birth control is important if avoiding pregnancy is the goal.
You can safely use hormone free methods, no matter what your breast cancer type, stage, or hormone receptor status (A type of breast cancer where the cancer cells have receptors for estrogen and/or progesterone. These cancers can be fueled by hormones, which affects birth control choices. or A type of breast cancer where the cancer cells do not have receptors for estrogen or progesterone. People with HR-negative cancers may have more birth control options.). These are:
- The A hormone-free IUD wrapped in copper that prevents pregnancy for up to 10-12 years. The copper creates an environment toxic to sperm. The Copper IUD can also be used as emergency contraception.
- Birth control methods that involve tracking your menstrual cycle to identify fertile days and avoiding sex or using barrier methods during that time. Also called natural family planning. (avoiding sex when you are fertile)
- Things you use or do at the time of sex
- Condoms, spermicides, vaginal gel, pull-out, and others
- A permanent surgical procedure that closes or blocks the fallopian tubes to prevent pregnancy. Also known as "getting your tubes tied." This is a hormone-free option. (female sterilization)
- A permanent surgical procedure for people with testes that cuts or blocks the tubes that carry sperm. A hormone-free option that doesn't affect sexual function. (male sterilization)
Hormonal birth control methods are the most commonly used methods at the time people are diagnosed with breast cancer.
Many people may ask “What is my risk of breast cancer in the future if I use hormonal birth control after cancer treatment?”
Unfortunately, more studies need to be done to best answer this question for pre-menopausal patients with breast cancer.
BUT, based on the latest research and what we know about how the body works, we recommend the following…
If your top priority is avoiding a new or returning breast cancer over anything else (such as possible benefits of hormonal birth control), you should stay away from all hormonal birth control methods.
This includes hormonal methods that have both A hormone that plays a key role in the reproductive system. Combined hormonal contraceptives contain estrogen, which is generally not recommended for people with hormone receptor-positive breast cancer. and A synthetic form of the hormone progesterone used in many birth control methods. Progestin-only methods are often recommended for breast cancer survivors because they don't contain estrogen. (a type of progesterone), as well as those that only have progestin – no matter what your hormone receptor is.
We know that for some people, under certain situations, the pros of hormonal birth control may outweigh the concerns about a new or returning breast cancer.
The decision to use hormonal birth control should be made on a case-by-case basis in discussion with the healthcare team prescribing your birth control and with your team of cancer specialists.
Birth control used after unprotected sex to prevent pregnancy. Options include emergency contraceptive pills (like Plan B or ella) and the copper IUD. Most effective when used as soon as possible. pills are taken after sex (penis-in-the-vagina) to prevent pregnancy. These are also called “morning after” pills or a backup to regular birth control. EC pills are not abortion pills.
If you had sex without birth control, did not use your birth control as directed, or were forced to have sex less than 5 days ago, you can still use emergency contraception (EC) to prevent pregnancy.
Short-term use of EC pills does not raise the risk of breast cancer. EC pills are safe to use regardless of HR status.
There are two types of EC pills in the United States:
- Over the Counter (OTC) EC pills: OTC EC pills can be bought without a prescription at a pharmacy or online. Common brands include Plan B One-Step, Next Choice One Dose, Next Choice, and My Way. If taken correctly within 5 days after sex, OTC EC pills lower the risk of pregnancy by 70%. They work best if taken within 24 hours of sex. For people who weigh 154 lb (70 kg) or more, OTC EC pills may not be as effective.
- Prescription EC pill: This is a single pill called A brand of emergency contraception pill containing ulipristal acetate. Requires a prescription. Effective up to 5 days (120 hours) after unprotected sex.. You need a prescription to get Ella. Ella works better than OTC EC pills. If taken within 5 days after sex, Ella lowers the risk of pregnancy by 85%. Ella is not affected by how much time has passed since sex- it works just as well on day 1 as on day 5. For people who weigh 194 lb (88 kg).
TheA hormone-free IUD wrapped in copper that prevents pregnancy for up to 10-12 years. The copper creates an environment toxic to sperm. The Copper IUD can also be used as emergency contraception. can be used for emergency contraception, and it works a lot better than EC pills.