3.5 Special considerations

3.5 Special considerations

Special considerations that need to be addressed at this stage include issues regarding fertility, early menopause and changes to sexual function.

The risk of early-onset menopause continues after chemotherapy/radiotherapy and not only immediately following treatment. Referral for psychological services or a women’s health or sexual and reproductive health practitioner may be appropriate regarding changes to sexual function and loss of fertility, particularly for younger women.

The option of fertility preservation needs to be discussed prior to treatment starting. Referral to a fertility service for counselling and evaluation of options may be appropriate. Fertility-sparing

approaches may be considered in highly selected patients who have been thoroughly counselled regarding disease risk as well as prenatal and perinatal issues (NCCN 2017).

Referral to a social worker, women’s health physiotherapist, psychosexual counsellor, menopause expert, psychologist or psychiatrist may be appropriate.