Receiving a breast cancer diagnosis can be overwhelming. If you’re already managing menopause and relying on hormone replacement therapy (HRT) to relieve symptoms such as hot flushes, night sweats, poor sleep or vaginal dryness, being told you may need to stop HRT can add another layer of uncertainty. 

Many women have questions about HRT and breast cancer, including whether they need to stop HRT immediately, why their doctor has recommended this, and what options are available to manage menopause symptoms safely after diagnosis. 

The good news is that support is available. While stopping HRT may cause menopause symptoms to return or worsen, there are a range of evidence-based strategies that can help improve your quality of life during and after breast cancer treatment. 

Understanding why treatment recommendations change, what to expect after stopping HRT, and the options available to help manage menopause symptoms can help you feel more informed and confident as you navigate treatment.

What is hormone replacement therapy (HRT)?

Hormone replacement therapy (HRT), sometimes called menopausal hormone therapy (MHT), is a treatment used to help relieve menopause symptoms caused by falling hormone levels, particularly oestrogen. 

Many women use HRT to improve their quality of life during menopause. Depending on your symptoms and medical history, it may include oestrogen alone or a combination of oestrogen and progesterone. 

HRT can help reduce symptoms such as: 

• Hot flushes  

• Night sweats  

• Sleep disturbances  

• Mood changes  

• Vaginal dryness  

• Pain during sex  

• Joint aches  

For many women, these symptoms can significantly affect work, relationships and everyday wellbeing. 

What happens if you’re diagnosed with breast cancer while taking HRT?

If you’re diagnosed with breast cancer while taking HRT, your treatment team may recommend stopping HRT. Whether this is necessary depends on several factors, including the type of breast cancer you have, your medical history and your individual treatment plan. 

For many women, particularly those diagnosed with hormone receptor-positive breast cancer, doctors may recommend stopping HRT after breast cancer diagnosis. 

Why do doctors recommend stopping HRT? 

Some breast cancers grow in response to hormones such as oestrogen or progesterone, including hormone receptor-positive breast cancers. 

 Because HRT contains hormones that may stimulate the growth of these cancers, your healthcare team may recommend that you stop taking HRT. This recommendation can come as a shock, particularly if HRT has been helping you manage difficult menopause symptoms for many years. However, your treatment team will always consider your individual situation before making recommendations. 

Some complementary medicines for the treatment of menopause like red clover and dong quai may also be recommended to be ceased. This is because they have oestrogen like effects in the body that could stimulate the growth of breast cancer cells. It is important to always discuss your medications and supplements with your doctor following a diagnosis of breast cancer. 

Not everyone will receive the same advice. Some women with hormone receptor-negative breast cancer or particular medical circumstances may have different treatment considerations. 

Decisions should always be individual

There isn’t a one-size-fits-all answer when it comes to menopause hormone therapy and breast cancer. 

These decisions should always be made in consultation with your healthcare team, who can explain the risks and benefits based on your individual situation. 

It’s important not to stop or restart HRT without discussing it with your healthcare team. 

Why can menopause symptoms suddenly become worse? 

Many women are surprised by how quickly their menopause symptoms return after stopping HRT. 

Unlike natural menopause, where hormone levels decline gradually over several years, stopping HRT can cause a sudden drop in hormone levels. Some women describe this as “going cold turkey” – an informal phrase used to describe stopping a treatment abruptly. While it isn’t a medical term, it reflects how quickly symptoms can return. 

Because your body no longer receives replacement hormones, symptoms may reappear within days or weeks. They can also feel more intense than you remember before starting HRT. This sudden hormonal change can be especially challenging when you’re also coping with a new breast cancer diagnosis and beginning treatment. 

Common Menopause Symptoms After Stopping HRT 

Stopping HRT can cause menopause symptoms to return quickly, and for some women they may feel more intense than they were before starting treatment. Every woman’s experience is different. Some may notice only a few mild symptoms, while others find that menopausal symptoms have a significant impact on their daily life. 

Common menopause symptoms after stopping HRT include: 

Hot flushes and night sweats 

Hot flushes and night sweats are among the most common symptoms women experience after stopping HRT. They may occur several times a day or night and can disrupt sleep, affect concentration and make everyday activities more challenging. 

Sleep disruption 

Hot flushes, night sweats and hormonal changes can all interfere with sleep. Poor sleep may leave you feeling tired during the day and make it harder to cope with other menopausal symptoms as well as the physical and emotional demands of breast cancer treatment. 

Mood changes and anxiety 

Changes in hormone levels can affect your mood. Some women experience increased anxiety, irritability or low mood after stopping HRT, particularly while adjusting to a breast cancer diagnosis and treatment. 

Brain fog 

Difficulty concentrating, forgetfulness or feeling mentally “foggy” are common menopause symptoms. These changes may also be influenced by stress, lack of sleep and some breast cancer treatments. 

Vaginal dryness and reduced libido 

Lower oestrogen levels can reduce the natural moisture and elasticity of the vaginal tissues, leading to dryness, irritation or discomfort. Many women also notice changes in their sex drive. These symptoms can affect confidence, intimacy and relationships, but there are treatments and supportive strategies that may help. 

Joint pain and fatigue 

Some women experience aching joints, muscle stiffness or persistent fatigue after stopping HRT. These symptoms can also occur during breast cancer treatment, making it important to discuss any new or worsening symptoms with your healthcare team.

Many of these symptoms overlap with treatment-induced menopause, which can occur as a result of chemotherapy, ovarian suppression, surgical removal of the ovaries or endocrine therapy. To learn more about recognising and managing these symptoms, read our guide to Menopause and Breast Cancer: Symptoms, Side Effects and Managing Treatment-Induced Menopause. 

Managing Menopause Symptoms Without HRT 

Whilst HRT is a very effective treatment for many menopausal symptoms, being told to stop HRT doesn’t mean you have to simply live with difficult menopause symptoms. There are a range of evidence-based approaches that can help improve your comfort and quality of life during and after breast cancer treatment. 

The most appropriate options will depend on your symptoms, your breast cancer diagnosis and treatment and your overall health, so it’s important to discuss them with your healthcare team. 

Lifestyle changes 

Simple lifestyle changes may help improve menopause symptoms and make them more manageable. Keeping your bedroom cool, dressing in layers, identifying triggers such as alcohol or spicy foods, and practising relaxation techniques can all make a difference. Our Supportive Care in Breast Cancer Q&A also explores practical strategies for managing treatment side effects and improving quality of life. 

Regular exercise 

Regular physical activity has been shown to improve overall wellbeing and help reduce fatigue, improve sleep, address hot flushes and joint pain, and boost mood. It also supports weight management, cardiovascular health and bone density while reducing the risk of chronic disease. Learn more in our guide to Exercise for Breast Cancer Patients or watch our The Role and Impact of Diet and Exercise in Breast Cancer Q&A, where experts discuss the benefits of staying active during and after treatment. 

Prioritising good sleep 

Establishing a regular sleep routine, limiting caffeine later in the day and reducing screen time before bed may help improve sleep quality, particularly if hot flushes or night sweats are disrupting your rest. Exercise, yoga and hypnosis can also help improve sleep.  

Vaginal moisturisers and lubricants 

For women experiencing vaginal dryness, non-hormonal vaginal moisturisers and lubricants can help improve comfort during everyday activities and intimacy. Your healthcare team can recommend products that may be suitable for you. 

Non-hormonal medications 

Some prescription medications that do not contain hormones may help manage symptoms such as hot flushes. These include a class of medications called NK3 receptor antagonists such as fezolinetant, as well as epilepsy treatments and antidepressants. These are not suitable for everyone, so discuss the potential benefits and side effects with your treating team. 

Psychological support 

Managing mood changes during menopause is important for overall wellbeing and quality of life. It may also help with other menopause symptoms, such as hot flushes, which can be made worse by stress. A breast cancer diagnosis and treatment can bring additional emotional challenges during this time. 

Counselling, psychology services, peer support and supportive care programs can all play an important role.  Some psychological treatments such as cognitive behavioural therapy can help women cope with the impact of menopausal symptoms whilst also increasing wellbeing. You can learn more about the services available in our Supportive Care resource and The Psychological Impact of Breast Cancer, which explores the emotional effects of diagnosis and treatment. 

If your menopause symptoms are affecting your quality of life, don’t try to manage them alone. Speak with your healthcare team about your symptoms. They can work with you to develop a personalised management plan and recommend evidence-based options that are appropriate for your individual circumstances. 

What’s the Difference Between HRT and Hormone Therapy for Breast Cancer? 

Although they sound similar, hormone replacement therapy (HRT) and hormone therapy for breast cancer are two very different treatments with different purposes. 

Hormone replacement therapy (HRT) is used to help relieve menopause symptoms by replacing hormones, such as oestrogen, that naturally decline during menopause. 

Hormone therapy for breast cancer, also known as endocrine therapy, works in the opposite way. Rather than replacing hormones, it blocks or lowers the effects of oestrogen in the body to help slow or stop the growth of hormone receptor-positive breast cancers. 

This difference is why women diagnosed with hormone receptor-positive breast cancer are often advised to stop HRT before starting breast cancer treatment. 

Can I Ever Use HRT Again After Breast Cancer? 

Whether HRT can be used again depends on your individual circumstances and should always be discussed with your healthcare team. 

HRT may be considered based on several factors, including: 

• The type and stage of breast cancer you were diagnosed with  
• Whether your cancer is hormone receptor-positive or hormone receptor-negative  
• The severity of your menopause symptoms  
• Your overall health and medical history  
• The potential risks and benefits of HRT 
• The efficacy of non-hormonal treatments

In some situations, particularly where symptoms are severe and significantly affecting quality of life, and non hormonal treatments have been unsuccessful, your treating team may discuss whether HRT is appropriate after carefully considering the potential risks and benefits. This is increasingly so for low dose vaginal oestrogen therapy for the treatment of vaginal dryness and urinary symptoms which has evidence of safety in breast cancer.

These decisions are highly individual and should always be made in consultation with your healthcare team. 

If you’re struggling with menopause symptoms after stopping HRT, don’t restart treatment on your own. Speak with your healthcare team about the options available to help manage your symptoms safely and effectively. 

Join our free Menopause and Breast Cancer Q&A

Have questions about menopause during or after breast cancer treatment? 

Join our free online Menopause and Breast Cancer Q&A, where leading breast cancer specialists and women with lived experience will answer common questions about treatment-induced menopause, managing symptoms, HRT and the latest in research. 

Register now to have your questions answered by the experts. 

What is menopause?

Menopause is a natural stage of life when the ovaries gradually produce less oestrogen and menstrual periods permanently stop. While it usually occurs as part of ageing, some breast cancer treatments can cause menopause earlier than expected or trigger menopause-like symptoms. 

Known as treatment-induced menopause, this can happen after chemotherapy, ovarian suppression, surgery to remove the ovaries, radiation therapy to the ovaries, or when hormone replacement therapy (HRT) is stopped following a breast cancer diagnosis. Some hormone therapies, such as tamoxifen and aromatase inhibitors, don’t usually cause menopause itself but can lead to symptoms commonly associated with menopause. 

A woman is considered to have reached menopause after she has gone 12 consecutive months without a menstrual period, provided there is no other medical reason for her periods stopping. When menopause occurs naturally, these hormonal changes usually happen gradually over several years. In contrast, treatment-induced menopause following breast cancer treatment can occur within weeks or months, leading to a more sudden onset of symptoms. 

As a result, symptoms such as hot flushes, night sweats, vaginal dryness, sleep disturbances, brain fog, joint pain and mood changes can feel more intense and have a greater impact on quality of life. 

This guide explains the different types of menopause, how breast cancer treatments may affect your hormones, common menopause symptoms after breast cancer, and practical ways to manage them during and after treatment. 

The three stages of menopause

Menopause is a process rather than a single event. It is generally divided into three stages. 

Perimenopause

Perimenopause is the transition leading up to menopause. During this time, hormone levels begin to fluctuate, particularly oestrogen, causing menstrual periods to become irregular. Perimenopause can last anywhere from a few months to several years before menopause occurs.

Menopause 

Menopause is confirmed after 12 months without a menstrual period. 

The average age of natural menopause in Australia is around 51 years, although it may occur earlier or later. 

Post-menopause 

Post-menopause refers to the years after menopause. Although symptoms such as hot flushes often improve over time, lower oestrogen levels continue to affect the body and can increase the risk of osteoporosis, heart disease, and changes to vaginal and urinary health. 

Regular exercise, good nutrition and ongoing healthcare are important for maintaining long-term health after menopause. 

Menopause and breast cancer risk: Is there a link? 

Menopause itself does not cause breast cancer. However, because most women go through menopause in their late 40s or early 50s, and the risk of breast cancer increases with age, most breast cancers are diagnosed after menopause. 

Women who experience menopause later than average (after around age 55) have a slightly higher risk of developing breast cancer than women who experience menopause earlier. This is because breast tissue is exposed to naturally occurring oestrogen for a longer period of time, which may slightly increase the risk breast cancer, particularly hormone receptor-positive breast cancer. 

Breast cancer risk is influenced by many factors, including age, family history, inherited genetic mutations, reproductive history, and lifestyle factors. If you’d like to better understand your personal risk, Breast Cancer Trials provides information about breast cancer prevention and the iPrevent breast cancer risk assessment tool, which can help women discuss their individual risk with their GP or healthcare team. 

Can breast cancer treatment cause menopause?

Yes. Some breast cancer treatments can cause menopause either temporarily or permanently, while others can trigger menopause-like symptoms by reducing or blocking the effects of oestrogen in the body. This is known as treatment-induced menopause, medical menopause or induced menopause. 

Unlike natural menopause, which develops gradually over several years, treatment-induced menopause often occurs suddenly because hormone levels change much more rapidly. 

Whether menopause is temporary or permanent depends on several factors, including your age, the type of treatment you receive and how your ovaries respond to treatment. There is currently no reliable test that can predict whether ovarian function will return after treatment. 

For women who haven’t yet started or completed their family, some breast cancer treatments may also affect fertility. If preserving your fertility is important to you, speak with your treatment team about fertility preservation options before treatment begins. 

Research is continuing to improve the way menopause and fertility are managed during breast cancer treatment. For example, the POEMS clinical trial, led by Breast Cancer Trials in collaboration with international researchers, found that temporary ovarian suppression with a medicine called goserelin during chemotherapy reduced the risk of premature ovarian insufficiency and improved the chance of future pregnancy in some premenopausal women with hormone receptor-negative breast cancer. 

Which breast cancer treatments can cause menopause?

Not all breast cancer treatments cause menopause, and not everyone will experience menopause during or after treatment. Whether menopause occurs depends on your age, the type of treatment you receive, and how your ovaries respond to treatment. 

Some treatments affect the ovaries directly and may lead to temporary or permanent menopause. Others don’t cause menopause itself but lower oestrogen levels or block its effects, resulting in menopause-like symptoms. 

Chemotherapy and menopause

Chemotherapy can affect the ovaries and reduce their ability to produce oestrogen. As a result, some women stop having periods during treatment and experience symptoms of menopause. 

For some women, ovarian function returns after chemotherapy finishes. For others, chemotherapy may cause permanent menopause. The likelihood depends on several factors, including your age, the chemotherapy medicines used, whether ovarian suppression is used, and your ovarian function before treatment. 

Common symptoms may include: 

• Hot flushes after chemotherapy  
• Night sweats  
• Irregular or absent periods  
• Vaginal dryness  
• Mood changes  
• Sleep disturbance  

If preserving your fertility is important to you, discuss fertility preservation options with your treatment team before treatment begins. 

Hormone therapy and menopause

Hormone therapy (also called endocrine therapy) is used to treat hormone receptor-positive breast cancer. These medicines work by lowering the amount of oestrogen available to breast cancer cells or blocking its effects in different parts of the body. 

While hormone therapy doesn’t always cause menopause, it commonly causes menopause-like symptoms. 

Tamoxifen and fulvestrant and menopause 

Tamoxifen is commonly prescribed for women with hormone receptor-positive breast cancer and can be used before or after menopause. It works by blocking oestrogen receptors on breast cancer cells, helping to reduce the risk of the cancer returning. 

Fulvestrant is an injection that works by degrading the oestrogen receptors on breast cancer and other cells. This means that oestrogen can not stimulate breast cancer cells to grow.. 

Although tamoxifen and fulvestrant do not cause menopause, they commonly causes menopausal symptoms, including: 

• hot flushes  
• night sweats  
• vaginal dryness  
• reduced libido  
• mood changes  
• changes to menstrual periods.  

Some women continue to have periods while taking Tamoxifen, while others find their periods become irregular or stop altogether. In contrast, fulvestrant does not cause periods to stop but is commonly used in combination with ovarian suppression in premenopausal women which does stop women from having their period. 

Aromatase inhibitors and menopause

Aromatase inhibitors, including anastrozole, letrozole and exemestane, lower the amount of oestrogen produced in the body. They are generally prescribed for women who have gone through menopause or whose ovarian function has been medically suppressed who still produce a small amount of oestrogen in their fat and other tissues.  

Because these medicines further reduce oestrogen levels, they commonly cause menopause-related side effects such as: 

• hot flushes  
• vaginal dryness  
• joint and muscle pain  
• low mood  
• reduced bone density.  

Lower oestrogen levels can increase the risk of osteoporosis, so your treating team may recommend bone density scans before and during treatment. Weight-bearing exercise, adequate calcium and vitamin D, and medicines to strengthen bones may also be recommended where appropriate. Research from the IBIS-II trial found that bone density generally stabilised and may improve slightly after stopping aromatase inhibitors. 

Ovarian suppression and menopause

For some premenopausal women with hormone receptor-positive breast cancer, ovarian suppression may be recommended as part of their hormone treatment. This temporarily stops the ovaries from producing oestrogen, helping to further reduce the amount of hormone available to breast cancer cells.  

Ovarian suppression is commonly achieved using medicines such as goserelin (Zoladex), which is given as a regular injection. It is mostly used in conjunction with either tamoxifen or an aromatase inhibitor. 

Because oestrogen levels fall quickly, menopause symptoms often begin soon after treatment starts. 

Not all pre-menopausal women need ovarian suppression, but for those at risk of breast cancer recurrence it is an important way to escalate hormone therapy. This was shown in the SOFT and TEXT trials in which BCT participated which were pivotal in demonstrating this benefit for young women. 

Some pre-menopausal women are also recommended ovarian suppression even if they don’t have hormone receptor positive breast cancer. This is to protect the ovaries from chemotherapy related treatment induced menopause as shown in the POEMS trial. 

Ovary removal and menopause (surgical menopause)

Surgical removal of both ovaries (bilateral oophorectomy) causes immediate, permanent menopause because the ovaries stop producing oestrogen. This may be recommended as an alternative to temporary ovarian suppression as part of hormone therapy for pre-menopausal women at risk of recurrent breast cancer. This may also be recommended for some women with breast cancer and an inherited BRCA1 or BRCA2 gene mutation to reduce their risk of ovarian cancer.  

Because hormone levels fall suddenly, symptoms can be more intense than during natural menopause. Women may also require ongoing monitoring of their bone health and cardiovascular health because lower oestrogen levels increase the long-term risk of osteoporosis and heart disease. 

Less commonly, women can have radiotherapy to ablate the ovaries. In this situation, the ovaries remain but are no longer able to produce estrogen. This option is usually used when an operation is not recommended.  

Stopping hormone replacement therapy (HRT)

Some women are already using hormone replacement therapy (HRT), also called menopausal hormone therapies (MHT), to manage menopause symptoms when they are diagnosed with breast cancer. 

For many women with breast cancer, particularly women with hormone receptor-positive breast cancer, systemic menopausal hormone therapy is generally not recommended, so your treating team may advise you to stop taking HRT. This can result in sudden return or worsening of menopause symptoms.  

If you’re taking HRT when you’re diagnosed with breast cancer, speak with your healthcare team before making any changes. They can discuss the safest approach for your individual situation and recommend non-hormonal options to help manage your symptoms. 

How different breast cancer treatments may affect menopause

Common menopause symptoms and side effects after breast cancer treatment

Menopause symptoms after breast cancer treatment can affect many aspects of your physical, emotional and sexual wellbeing. While some women experience only mild symptoms, others find that treatment-induced menopause has a significant impact on their daily life.  

The symptoms experienced will depend on factors such as your age, the treatments you’ve received and how quickly your hormone levels change. Not everyone experiences the same symptoms, and they can vary in severity and duration. 

Why are treatment-induced menopause symptoms often more severe?

Many women find that treatment-induced menopause feels more intense than natural menopause. That’s because natural menopause usually develops gradually over several years, giving the body time to adjust to slowly changing hormone levels. 

In contrast, breast cancer treatments such as chemotherapy, ovarian suppression, surgery to remove the ovaries or radiation to the ovaries can cause hormone levels to fall rapidly. This sudden drop in oestrogen can trigger menopause symptoms that are more noticeable or severe. 

Women who stop hormone replacement therapy (HRT) after a breast cancer diagnosis may also experience a sudden return of menopause symptoms because the body is no longer receiving replacement hormones. 

The severity of symptoms varies from person to person. The good news is that many menopause symptoms improve over time, and a range of treatments and supportive care options are available to help manage them. 

Looking after your health after menopause

Whether menopause occurs naturally or as a result of breast cancer treatment, looking after your long-term health is important. 

Bone health

Lower oestrogen levels can increase the risk of osteoporosis, making bones weaker and more likely to fracture. This is particularly important for women who experience early menopause or are taking aromatase inhibitors. 

Your healthcare team may recommend: 

• bone density (DEXA) scans  
• regular weight-bearing and resistance exercise  
• adequate calcium and vitamin D  
• medication to strengthen bones if required.  

Heart health 

Lower oestrogen levels after menopause contribute to an increased risk of cardiovascular disease over time. After menopause, the risk of cardiovascular disease gradually increases. 

Simple lifestyle habits such as staying physically active, maintaining a healthy diet, not smoking and attending regular health checks can help reduce your risk. 

Watch one of our Q&A topics where we discuss heart health or listen to our podcast episode here.  

Follow-up care

Continue attending your scheduled follow-up appointments with your healthcare team, including your GP. These visits allow your doctors to monitor your recovery, manage any ongoing side effects and discuss any new symptoms or concerns. 

If menopause symptoms are affecting your quality of life, don’t assume they’re something you simply have to live with. Many effective treatments and supportive care options are available. 

Join our free Menopause and Breast Cancer Q&A

Have questions about menopause during or after breast cancer treatment? 

Join our free online Menopause and Breast Cancer Q&A, where leading breast cancer specialists and women with lived experience will answer common questions about treatment-induced menopause, managing symptoms, HRT and the latest in research. 

Register now to have your questions answered by the experts. 

A diagnosis of breast cancer can be particularly confronting for women who are still planning to have children or who are currently pregnant. Many women immediately wonder whether treatment will affect their fertility, whether pregnancy will still be possible in the future, or whether trying to conceive after treatment could increase the risk of cancer returning. 

The reassuring news is that many women can still have children after breast cancer treatment, and research continues to improve fertility options and pregnancy outcomes for women diagnosed during their reproductive years. Breast cancer can also occur during pregnancy, although this is uncommon, and specialised medical teams work carefully to protect both mother and baby, emphasising the importance of tailored pregnancy and breast cancer treatment. 

Understanding the relationship between fertility, pregnancy and breast cancer can help women make informed decisions about treatment and future family planning. This guide explains how breast cancer treatments may affect fertility, options such as egg freezing and IVF, pregnancy after treatment, and the specialist care available in Australia.  

How Breast Cancer Treatment Can Affect Fertility 

Some breast cancer treatments can affect the ovaries and the body’s ability to conceive. However, the impact varies widely depending on factors such as age, the type of treatment used, and how the ovaries respond. 

Chemotherapy and fertility

Chemotherapy works by targeting rapidly dividing cells. While this is effective against cancer cells, it can also affect healthy cells, including those in the ovaries that produce eggs. Different chemotherapies impact the ovaries to varying degrees. As a result, some women may experience: 

• Temporary infertility 
• Reduced fertility 
• Permanent infertility in some cases 

Younger women generally have a higher chance of ovarian recovery after treatment compared with older women. 

Some women also experience early menopause, particularly if chemotherapy significantly affects ovarian function. 

Breast cancer treatment can also delay pregnancy plans. For some women, treatment may continue for several years, particularly if hormone therapy is recommended after chemotherapy or surgery. This delay can reduce fertility opportunities over time, especially as natural fertility declines with age. Discussing future family plans with your healthcare team before treatment begins can help you understand your options and consider fertility preservation if appropriate. 

Tamoxifen and fertility

Tamoxifen is a hormone therapy commonly used to reduce the risk of breast cancer returning. It is typically taken for five to ten years, which can delay pregnancy plans as pregnancy is not recommended whilst taking tamoxifen. 

Because fertility decisions are time-sensitive, it is important to discuss fertility preservation before breast cancer treatment begins. 

Research improving fertility options 

Australian researchers have played an important role in improving fertility outcomes for women with breast cancer. The POEMS clinical trial, led by Breast Cancer Trials, showed that a medication called Zoladex (Goserelin) can be used to temporarily suppress ovarian function during chemotherapy and help protect fertility in some women. 

This research has helped expand options for women who hope to have children after treatment. 

Women are also encouraged to explore resources from organisations such as Cancer Australia and Breast Cancer Network Australia (BCNA) when considering fertility planning. 

Early Menopause and Breast Cancer 

Some women experience early menopause as a result of breast cancer treatment. 

Early menopause occurs when the ovaries stop functioning before the age of 45. Chemotherapy can damage ovarian tissue, reducing the body’s ability to produce hormones and eggs. 

Symptoms of early menopause may include: 

• Hot flushes 
• Sleep disturbances 
• Vaginal dryness 
• Mood changes 
• Reduced libido 

For younger women, the emotional impact of early menopause can be significant, particularly if they had hoped to have children in the future. Symptoms of menopause can also have a significant effect, impacting a woman’s ability to work, exercise and care for their family. 

Managing symptoms and understanding fertility implications are important parts of care. Women experiencing these effects may benefit from guidance from both oncology specialists and menopause or fertility experts. 

You can learn more in our guides on early-onset breast cancer, early menopause, and young women and breast cancer. 

Fertility and Breast Cancer Options

Several options are available to help preserve fertility before breast cancer treatment begins. These approaches are usually arranged quickly after diagnosis, before chemotherapy or other treatments start. 

Breast cancer and egg freezing

Egg freezing involves stimulating and then collecting mature eggs from the ovaries and storing them for future use. This allows women the possibility of pregnancy later, even if treatment affects ovarian function. 

Breast cancer and embryo freezing

Embryo freezing is similar to egg freezing but involves collecting and then fertilising the eggs with sperm before freezing them. This process is known as in vitro fertilization (IVF). 

This option is the most reliable and may be suitable for women who have a partner or who wish to use donor sperm. 

Ovarian tissue freezing (ovarian tissue cryopreservation)

Ovarian tissue freezing is an emerging fertility preservation technique. A small amount of ovarian tissue is removed and stored for later transplantation. The transplanted ovarian tissue is then able to produce both eggs to restore fertility, as well hormones to prevent early menopause. 

This approach is newer but still considered an option to preserve fertility and may offer hope for some women. 

Ovarian suppression during chemotherapy 

Medications can sometimes be used during chemotherapy to temporarily suppress ovarian activity, which may reduce the risk of treatment-related infertility. 

The POEMS clinical trial conducted by Breast Cancer Trials, helped demonstrate the potential benefit of this approach. 

Timing and specialist referral 

Fertility preservation treatments usually need to be completed before chemotherapy begins, so early referral to a fertility specialist is important. 

In Australia, access to fertility services may be supported through Medicare and private fertility clinics, depending on the procedure. 

You can listen to our Q&A about breast cancer and fertility, moderated by Author and Journalist Annabel Crabb, here. 

Pregnancy After Breast Cancer – Is It Safe? 

Many women worry that pregnancy after breast cancer could increase the risk of recurrence.  

While individual circumstances vary, pregnancy after breast cancer does not increase the risk of cancer returning for most women. 

In many cases, survival outcomes for women who become pregnant after treatment are similar to those who do not. This is also true for patients with hormone receptor positive breast cancers and those with BRCA 1 or BRCA 2 mutations. 

Research shows that babies born to women who have previously had breast cancer generally do just as well as those born to women without a history of cancer. They experience normal growth and development, with no increased risk of birth defects, stillbirth, neonatal death or other major health problems. 

Doctors often recommend waiting around two years after treatment before trying to conceive, as this is when the breast cancer recurrence risk is typically highest. However, timing recommendations vary depending on the individual situation. 

Pausing endocrine therapy to try for pregnancy 

For some women with hormone receptor-positive breast cancer, endocrine therapy such as tamoxifen is recommended for five to ten years after treatment. This can delay plans to start or grow a family. 

The international POSITIVE clinical trial is investigating whether temporarily pausing endocrine therapy to attempt pregnancy is safe. Early results suggest that a planned interruption does not increase the short-term risk of breast cancer recurrence. However, longer-term follow-up is still underway, and any decision to pause treatment should be made in consultation with your treating team. 

Breast Cancer and Reproductive Concerns 

Even with reassuring research, many women experience anxiety about pregnancy after breast cancer. 

Common concerns include: 

• Fear of cancer recurrence 
• Concerns about hormone exposure during pregnancy 
• Emotional stress related to fertility decisions 

Oncofertility specialists and counselling services can help women navigate these complex decisions. 

Breast Cancer and IVF 

Some women require IVF (in vitro fertilisation) for infertility after breast cancer treatment. A common concern is whether IVF fertility injections could increase the risk of breast cancer developing or returning. 

IVF involves hormonal stimulation to encourage the ovaries to produce multiple eggs. Because these medications can temporarily increase oestrogen levels, some women worry about the potential link with breast cancer. 

Current research suggests that IVF does not significantly increase breast cancer risk in the general population. It appears to be safe in women with a history of breast cancer, even hormone receptor positive breast cancer. It also appears to be safe in those with inherited genetic mutations, such as BRCA1 or BRCA2. However individual risks may differ and personalised advice from specialists should always be sought when considering IVF after breast cancer. 

Consulting both a fertility specialist and an oncology team can help ensure treatment plans are safe and appropriate. Some women require multiple IVF cycles to retrieve enough eggs. Current evidence does not link repeated egg retrieval cycles with an increase in breast cancer recurrence risk. However, long-term data on this topic remains limited. 

Individualised medical advice is recommended when planning fertility treatment. 

Do repeated egg retrieval cycles increase breast cancer risk?

Current research does not show strong evidence that repeated egg retrieval cycles or fertility treatments increase the risk of developing breast cancer or of breast cancer recurring. While these treatments involve short-term rises in hormones like oestrogen, no clear long-term link with breast cancer has been established.  

If you are considering egg freezing or IVF, it’s important to speak with your oncologist and fertility specialist to understand your individual risk and options. 

Breast Cancer During Pregnancy

Although uncommon, breast cancer during pregnancy can occur. International estimates suggest it affects around 1 in 3,000 pregnancies. 

Pregnancy does not cause breast cancer. However, hormonal changes and normal breast changes during pregnancy can sometimes make diagnosis more difficult. 

For this reason, any breast lumps or unusual change should be assessed promptly, even during pregnancy. 

When breast cancer is diagnosed during pregnancy, treatment decisions are made by a multidisciplinary team, including oncologists, obstetricians and surgeons experienced in caring for pregnant patients. 

Can breast cancer during pregnancy affect the baby?

Breast cancer itself does not spread to the baby and many treatments can still be safely given during pregnancy with careful monitoring. 

For example: 

• Surgery is generally safe during pregnancy 
• Chemotherapy may be possible during the second and third trimesters 
• Radiotherapy and hormone therapy are usually delayed until after birth 

Close monitoring throughout pregnancy helps ensure both maternal and foetal health. 

Treatment Options for Breast Cancer During Pregnancy 

Breast cancer treatment during pregnancy requires careful planning to balance effective cancer treatment with the safety of the developing baby. 

• Surgery – Breast surgery is generally considered safe during all stages of pregnancy but is ideally performed after the first trimester. Procedures may include lumpectomy or mastectomy depending on the cancer type and stage.
• Chemotherapy – Chemotherapy is usually avoided during the first trimester, when the baby’s organs are forming. However, chemotherapy may be safely given during the second and third trimesters under specialist supervision. For more information on chemotherapy during pregnancy, view our dedicated article. 
• Radiotherapy during pregnancy – Radiotherapy is typically postponed until after delivery because radiation exposure may harm the developing baby.
• Endocrine therapy and pregnancy – Hormone therapies used to treat hormone-receptor-positive breast cancer are not recommended during pregnancy and are usually started after birth. Targeted therapy during pregnancy – Many targeted therapies are also avoided during pregnancy due to potential risks to the baby. Treatment decisions are always tailored to the individual situation. 

Birth Control After Breast Cancer Treatment

Women who have completed breast cancer treatment may still need reliable contraception, particularly while taking endocrine therapy. 

For women with hormone receptor-positive breast cancer, as well as those with HER2-positive or triple negative breast cancer, hormone-based contraceptives are generally avoided. These contraceptives contain oestrogen or progesterone, which may not be suitable after breast cancer treatment. Your healthcare team can recommend the most appropriate contraception option based on your individual circumstances. 

Non-hormonal options may be recommended, such as: 

• Copper intrauterine device (IUD) 
• Condoms or barrier methods 
• Fertility awareness methods in some cases 

Choosing the right contraception method should always involve discussion with a healthcare professional. 

Breast Cancer Research and Fertility in Australia

Research continues to improve fertility options for women diagnosed with breast cancer. 

Australian researchers and organisations such as Breast Cancer Trials are contributing to important studies on: 

• Fertility preservation techniques 
• Ovarian protection during chemotherapy 
• IVF safety after breast cancer 
• Hormone exposure and recurrence risk 

Clinical trials such as POEMS have already helped improve fertility outcomes for many women. 

Women interested in advancing research may consider discussing clinical trial participation with their healthcare team. 

Frequently Asked Questions

Join Our Free Q&A Webinars

Don’t miss an opportunity to stay informed about the latest in breast cancer research and care. Join our FREE Q&A webinars, where we cover important topics including whether more young women are being diagnosed with breast cancer.

Stay Connected with Breast Cancer Trials

Don’t miss an opportunity to stay informed about the latest in breast cancer research and care. Sign up to our researcher’s newsletter via the form below to stay up to date.