ABSTRACT
Gonadal dysfunctions and alterations in reproductive health are significant long-term morbidity in cancer survivors. This chapter reviews understanding of gonadal and sexual dysfunction and discusses status and future direction of fertility-preservation technologies for cancer survivors. The multimodality used in cancer treatment can result in premature menopause and menopause-related symptoms. In premenopausal breast cancer survivors, chemotherapy-related amenorrhea is the most significant long-term morbidity. The hot flush is the main adverse effect of administration of tamoxifen, a key drug for hormone receptor–positive breast cancer patients. The physician should discuss the details of the oncological and treatment profile of each patient with the oncologist and inform the patient of the lack of strong evidence when considering hormone replace treatment (HRT) for breast and endometrial cancer survivors. The contraindications of HRT in the general population include suspected and diagnosed prostate cancer and breast cancer, polycythemia, sleep apnea, severe heart failure, and severe symptoms of benign prostatic hypertrophy.
