Abemaciclib, fertility, menopause and sexual health

Abemaciclib itself is not thought to cause permanent menopause, but the treatment it is part of has major effects on fertility, periods and sexual health. It is always taken with hormone therapy, and women who are still having periods usually also have ovarian suppression injections, which switch the ovaries off for as long as they are given. That means periods stop and menopausal symptoms such as hot flushes, vaginal dryness, lower sex drive and mood changes are common. Many younger women have also had chemotherapy, which can reduce egg reserves and sometimes bring on early menopause. Abemaciclib can harm an unborn baby, so pregnancy must be avoided during treatment and for at least three weeks after the last dose. Hormonal contraceptives such as the pill are not suitable after breast cancer of this type, so non-hormonal methods such as a copper coil or condoms are usually advised. Breastfeeding is not recommended during treatment and for a few weeks after. For men, animal studies suggest abemaciclib may reduce fertility, so sperm storage can be discussed before starting. If having children in future matters to you, raise it as early as possible, ideally before any treatment begins, because options such as egg or embryo freezing need planning. Sexual problems during treatment are common and treatable, and it is completely reasonable to ask for help with them.

Pregnancy must be avoided

Use reliable non-hormonal contraception throughout treatment and for at least three weeks afterwards.

Periods usually stop

This is mainly because of ovarian suppression and hormone therapy, not abemaciclib alone.

Help is available

Vaginal dryness, pain during sex and low desire can all be eased with the right support.

These topics are often left unspoken in clinics, but they matter a great deal to many people.

Evidence on abemaciclib and fertility is limited

Most information comes from animal studies and from the effects of the treatments given alongside it.

Treatment lasts years

With hormone therapy usually continuing for five years or more, family planning needs careful discussion.

Periods may not return

Especially after chemotherapy or in women near natural menopause age.

What this page cannot tell you

It cannot predict your own fertility. A fertility specialist working with your oncologist can advise.

Hormone replacement therapy is generally not suitable after hormone-positive breast cancer, but other approaches help.

Hot flushes

Layered cotton clothing, a fan, avoiding triggers such as spicy food, and some non-hormonal medicines can reduce them. Check any medicine for interactions first.

Vaginal dryness

Regular vaginal moisturisers and water-based lubricants help. Low-dose vaginal oestrogen is sometimes considered, but only after discussion with your oncologist.

Low desire and relationships

Counselling, either alone or as a couple, can help, as can unhurried intimacy that is not focused only on intercourse.