Surgery, chemotherapy, radiotherapy and hormone treatment can cause changes in sex hormone levels.
Surgery to remove the ovaries
The ovaries make sex hormones. When the ovaries are removed by surgery, your sex hormone levels are lowered.
You might have both ovaries removed if you have ovarian cancer. This operation is called an oophorectomy (pronounced oo-for-ek-toe-mee).
If you have had your menopause, removing the ovaries won't cause symptoms. But if you are premenopausal, having your ovaries removed will make you go into menopause within a few days. This is called an early menopause.
Most women who have ovarian cancer have had their menopause, and therefore won't have hormone symptoms.
Some breast cancers are hormone sensitive and need oestrogen to grow. So stopping oestrogen production can slow down or stop cancer cell growth.
If you are premenopausal you might take medicines to switch off your ovaries. Or you might choose to have your ovaries removed. Either way, you will have a sudden menopause and have symptoms.
Surgery to remove the testes
The testes (testicles) make testosterone and so surgery to remove them lowers your sex hormone levels.
Surgery to remove the testicles is treatment for testicular cancer and sometimes prostate cancer. The operation is called an orchidectomy (pronounced or-kid-ek-toe-mee).
For most men testicular cancer only affects one testicle. Removing one testicle doesn’t have much effect on testosterone levels because the remaining testicle then makes enough.
In rare cases you could develop cancer in both testicles and would need to have both removed. You would then need testosterone replacement treatment to prevent hormone symptoms.
In prostate cancer, stopping testosterone production can slow down or stop cancer cell growth. So one treatment is to have your testicles removed. But most men have medicines to switch off testosterone production instead.
Chemotherapy is the use of anti cancer drugs (cytotoxics) to destroy cancer cells.
The effects on women
If you haven’t been through the menopause, chemotherapy can stop your ovaries working normally. This depends on:
- the type and dose of chemotherapy drugs you have
- your age
Your periods might stop temporarily. But if you are close to the age when you would naturally have your menopause, the chemotherapy might stop your periods permanently.
Young women treated with chemotherapy might have the menopause earlier. Your doctor will tell you if there is a risk of this happening. You might need to think about planning a family at a younger age because of the risk of early menopause.
The effects on men
There is less information about how chemotherapy affects testosterone levels. There is some evidence that it can lower testosterone during treatment. This can cause symptoms such as a reduced sex drive and tiredness.
Researchers have looked into sexual function after treatment for lymphoma. They found that men who had treatment for lymphoma had lower sexual function.
Lower sexual function included a reduced sex drive, and lower ability to have and maintain an erection. The researchers were unsure if this was due to lower testosterone levels or other factors such as increasing age, emotional distress or poorer physical health.
We need research to find out more about how chemotherapy affects testosterone. Testosterone levels usually return to normal after chemotherapy treatment has finished.
Radiotherapy to the pelvic area
Radiotherapy is the use of x-rays to treat cancer.
The pelvis is the area between your hip bones and contains the ovaries or testes, as well as the womb, bladder and prostate.
Radiotherapy to this area of the body can affect sex hormone levels.
You might have pelvic radiotherapy for cancers of the:
- prostate gland
Whenever possible your radiotherapy specialist will plan treatment to reduce the risk of lowered sex hormone levels.
Hormone therapy is a treatment for prostate, breast and womb cancer.
Hormone treatments can work in one of two ways:
- stopping the body making the hormone
- preventing the hormone from reaching receptors in the cancer cell
Whichever way the hormone therapy works, it can cause hormone symptoms.