Reproductive System Side Effects

21.03.2024

REPRODUCTIVE SYSTEM SIDE EFFECTS IN CANCER TREATMENT

Cancer treatment, especially chemotherapy, radiotherapy and some targeted treatments, can affect the reproductive system and cause various side effects. In men, these treatments can disrupt sperm production in the testicles, which can lead to temporary or permanent infertility. Loss of libido, erectile dysfunction and hormonal imbalances may also occur in men. In women, chemotherapy and radiotherapy can affect ovarian functions, which can cause menstrual irregularities, early menopause and infertility. Women may also experience problems such as decreased sexual desire, vaginal dryness and pain during intercourse. These side effects can also affect the emotional and psychological state of patients and cause significant changes in their quality of life. Information, counseling and support regarding reproductive health during and after cancer treatment are critical in managing these side effects. Considering fertility preservation options before and during treatment is important for patients' future reproductive plans.

Drugs that cause reproductive system side effects in cancer treatment include:

Alkylating Agents (Cyclophosphamide, Ifosfamide): It may cause infertility in men and women.

Platinum-Based Drugs (Cisplatin, Carboplatin): It may affect ovarian and testicular functions.

Antimetabolites (Methotrexate): May have harmful effects on the reproductive system.

Hormonal Therapies (Tamoxifen, Aromatase Inhibitors): It can have effects on the reproductive system by disrupting the hormone balance.

Gonadotropin Releasing Hormone (GnRH) Analogues: It may temporarily suppress reproductive functions.

It is important to pay attention to reproductive health and take necessary precautions when using these drugs.

TYPES OF SIDE EFFECTS

During cancer treatment, the effects of chemotherapy, radiotherapy and some targeted treatments on the reproductive system may be important. These side effects can occur differently in both men and women:

Side Effects Seen in Men

Infertility: Chemotherapy and radiotherapy can temporarily or permanently affect sperm production. Direct exposure of the testicles to radiation may cause a decrease in sperm production.

Loss of Libido and Sexual Dysfunctions: Treatments can lead to hormonal imbalances and decreased sexual desire. Erectile dysfunction may occur as a result of chemotherapy or radiotherapy.

Hormonal Changes: Testosterone levels may decrease, which has effects on energy levels and overall health.

Side Effects Seen in Women

Menstrual Irregularities and Early Menopause: Chemotherapy can damage the ovaries, causing menstrual irregularities or early menopause. Radiotherapy may affect ovarian functions, especially when applied to the pelvic area.

Infertility: Impairment of ovarian functions can lead to ovulation problems and infertility. Radiotherapy and some chemotherapy drugs can cause permanent ovarian damage.

Sexual Health Problems: Problems such as vaginal dryness, pain during intercourse, and decreased sexual desire may develop. Hormonal changes can have an impact on sexual health.

Image 1: During cancer treatment, the reproductive system in men and women can be affected and infertility can occur.

PRECAUTIONS AND TREATMENT

Since treatments such as chemotherapy, radiotherapy and some surgical interventions have a high potential to damage the reproductive system during the cancer treatment process, careful and advance planning is required to prevent infertility. Precautions that can be taken during this process vary depending on the patient's gender, age, cancer type, treatment plan and personal preferences.

PRECAUTIONS FOR MALE PATIENTS

Sperm Donation and Storage: It is the process of collecting and freezing sperm samples before treatment. This method is suitable for adults and teenage boys.

Testicular Sperm Extraction: It is a method of obtaining sperm directly from the testicle in patients with decreased or absent sperm production.

Testicular Tissue Donation: Removal and freezing of testicular tissue, especially for prepubertal boys.

Testis Protective Treatments: It is the process of using protective shields to protect the testicles during radiotherapy. Another method is to use drugs that have fewer testicular side effects during chemotherapy.

PRECAUTIONS FOR FEMALE PATIENTS

Embryo Donation and Storage: Collecting egg cells, fertilizing them with sperm, and freezing and storing the embryos.

Oocyte (Egg) Donation and Storage: Collecting and freezing egg cells. This method is suitable for women who do not have a partner or who do not prefer embryo donation.

Ovarian Tissue Cryopreservation: It is the process of removing a portion of the ovarian tissue and storing it by freezing. It can be reinserted into the body in the future and preserve the chance of pregnancy through hormone production.

Gonad Protective Treatments:It is the process of moving the ovaries out of the radiation field (oophoropexy) with protective shields or surgical intervention to protect the ovaries during radiotherapy.

Hormonal Protective Treatments: Some hormonal treatments (e.g. GnRH analogues) may be used to preserve ovarian function during chemotherapy.

Image 2: Cancer patients planning to have children should plan the process with their oncology doctor before cancer treatment begins.

GENERAL RECOMMENDATIONS AND THINGS TO CONSIDER

Consultation with a Fertility Specialist: Before treatment, it is necessary to consult with fertility specialists and evaluate reproductive options.

Hormonal Treatments: Hormone replacement treatments can be performed to correct hormonal imbalances. Treatments for sexual dysfunction may be helpful.

Education and Awareness Raising: It would be useful to get detailed information about infertility risks and prevention methods.

Psychological support: It may be useful to get psychological support for the risk of infertility and the emotional stress that the treatment process may cause.

Early and Comprehensive Planning: Decisions regarding reproductive health need to be made before treatment begins. Long-term breeding plans should be considered.

Multidisciplinary Approach:It is necessary to provide holistic patient care in collaboration with various physicians such as oncologists, endocrinologists, urologists, gynecologists and fertility specialists.

The effects of cancer treatment on reproductive health are different for each patient and therefore require individual evaluation and planning. Measures that can be taken to reduce the risk of infertility should be specific to the patient's condition and treatment plan. Early and thorough planning in this process can help patients preserve their future reproductive options.