Medical Oncologist
Fertility and menopause
Contraception while on tamoxifen or hormone therapy
Pregnancy is not safe on tamoxifen or other hormone therapy, and periods stopping does not rule it out. Hormonal contraception is generally avoided after breast cancer, so the copper coil and condoms are preferred. This page explains options, wash-out periods and gynaecological checks.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
- Which contraception is safe while taking tamoxifen or other hormone therapy?
- Contraceptive methods after breast cancer
- Contraceptive options compared, in general terms
- The vocabulary, in plain language
- Honest realities of contraception during hormone therapy
- What to expect from a copper coil
- Tamoxifen, bleeding and gynaecological checks
- Stopping contraception to try for a baby
- Contraception with ovarian suppression and aromatase inhibitors
- Talking with your partner about contraception
- What people assume about contraception on hormone therapy
- Common questions about contraception on hormone therapy
The short answer
Which contraception is safe while taking tamoxifen or other hormone therapy?
Women who have not gone through menopause need reliable contraception while taking hormone therapy for breast cancer, because pregnancy is not safe on these medicines. Tamoxifen can harm a developing baby, and it can also stimulate the ovaries in some premenopausal women, so pregnancy remains possible even if periods become irregular or stop. Most doctors advise continuing contraception during tamoxifen and for about two to three months after stopping it, to allow the medicine to clear from the body. Because many breast cancers are sensitive to hormones, hormonal contraception is generally not recommended after breast cancer. This includes the combined pill, contraceptive patch and vaginal ring, which contain oestrogen, and in most cases progestogen-only methods such as the progestogen-only pill, injection, implant and hormonal coil, although the hormonal coil is occasionally discussed in specific situations by specialists. The preferred options are non-hormonal. The copper intrauterine device, often called the copper coil, is highly effective, lasts for many years and contains no hormones. Condoms are hormone-free and also protect against infections. Permanent methods such as tubal sterilisation or a partner's vasectomy can suit couples who are sure their family is complete. Women on ovarian suppression with an aromatase inhibitor also need non-hormonal contraception, as ovarian suppression is not a reliable contraceptive on its own.
Do not rely on missed periods
Irregular or absent periods on hormone therapy do not mean you cannot become pregnant.
Plan with your team
Your oncologist and gynaecologist can help you choose the most suitable method.
Emergency contraception
A copper coil fitted soon after unprotected sex is an effective hormone-free option. Ask your team urgently if needed.
This page gives general information only. It is not a recommendation for any specific medicine or device.Methods
Contraceptive methods after breast cancer
Non-hormonal methods are usually preferred.
Copper coil
Hormone-free, highly effective and long-lasting.
Often the first choice for many women.Condoms
Hormone-free and protect against infections, but depend on correct use every time.
Sterilisation or vasectomy
Permanent options for couples who do not want more children.
Hormonal methods
Generally avoided after breast cancer.
Usually avoided
- Combined pill, patch and ring
- Progestogen-only pill, injection and implant
- Hormonal coil, except in specialist situations
Compared
Contraceptive options compared, in general terms
Method
Key points after breast cancer
Copper intrauterine device
Very effective; no hormones; periods may be heavier at first
Male or female condoms
No hormones; protect against infections; less effective with imperfect use
Diaphragm or cap
No hormones; needs correct use and fitting
Tubal sterilisation or vasectomy
Permanent; for couples certain their family is complete
Hormonal contraception
Generally not advised after breast cancer
Words you will hear
The vocabulary, in plain language
- Tamoxifen
- A hormone therapy tablet that blocks oestrogen in breast tissue.
- Copper IUD
- A small copper device placed in the womb to prevent pregnancy.
- Hormonal contraception
- Methods that use oestrogen or progestogen to prevent pregnancy.
- Wash-out period
- Time for a medicine to leave the body before pregnancy.
- Ovarian suppression
- Treatment that switches off the ovaries temporarily.
- Barrier method
- Contraception that physically blocks sperm, such as condoms.
Being straight with you
Honest realities of contraception during hormone therapy
Choosing contraception after breast cancer involves some compromises.
Fewer options
Avoiding hormonal methods leaves fewer choices than for other women.
Copper coil side effects
Heavier or more painful periods can occur, especially in the first few months.
Condoms need consistency
They are less effective if not used correctly every time.
Evidence on hormonal coils is mixed
Research on hormonal coils after breast cancer is limited, so they are usually avoided unless a specialist advises otherwise.
What this page cannot tell you
It cannot choose a method for you. Your gynaecologist and oncologist can.
The copper coil
What to expect from a copper coil
The copper coil is a popular hormone-free choice for women on hormone therapy.
How it works
Copper creates an environment in the womb that prevents sperm from fertilising an egg.
Fitting
A doctor or nurse inserts the coil through the cervix in a short clinic procedure. Some women feel cramping, which usually settles quickly.
How long it lasts
Depending on the type, a copper coil can work for five to ten years, and can be removed at any time.
Side effects
Periods may be heavier, longer or more painful, particularly early on.
Checks
You can feel for the threads to check it is in place, and see a doctor if you cannot.
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Gynaecological health
Tamoxifen, bleeding and gynaecological checks
Tamoxifen can affect the lining of the womb, so gynaecological awareness is important.
Irregular bleeding
Periods may become irregular on tamoxifen. Report unusual bleeding, especially after menopause.
Womb lining changes
Tamoxifen slightly increases the risk of changes in the womb lining, including rare womb cancer, mainly in postmenopausal women.
Coil and bleeding
If you have a copper coil and notice new bleeding patterns, your doctor may check both the coil and the womb lining.
Cervical screening
Continue routine cervical screening as advised.
Future pregnancy
Stopping contraception to try for a baby
If you hope to become pregnant in future, plan carefully with your oncologist.
Plan any pause
Hormone therapy should only be paused under supervision.
Allow the wash-out period
Wait about two to three months after stopping tamoxifen before trying to conceive.
Copper coil removal
Fertility returns quickly after a copper coil is removed.
Other hormone therapies
Contraception with ovarian suppression and aromatase inhibitors
Some premenopausal women take an aromatase inhibitor, such as letrozole, anastrozole or exemestane, together with ovarian suppression injections such as goserelin. Contraception needs particular care in this situation.
Ovarian suppression is not contraception
Injections that switch off the ovaries greatly reduce ovulation but cannot be relied on to prevent pregnancy, especially if an injection is late or the ovaries escape suppression.
Why this matters
If the ovaries restart while taking an aromatase inhibitor, oestrogen levels can rise, which may make the treatment less effective and allow pregnancy to occur. Blood tests are sometimes used to check that the ovaries remain suppressed.
Keep injections on time
Do not miss or delay ovarian suppression injections. Contact your team if an injection is overdue.
Use non-hormonal contraception
A copper coil or condoms are usually advised alongside ovarian suppression.
After menopause is confirmed
Once your doctors confirm you are postmenopausal, contraception may no longer be needed. Ask before stopping.
Together
Talking with your partner about contraception
Contraception is a shared responsibility.
Explain the risks
Help your partner understand why pregnancy is not safe on hormone therapy.
Plan for emergencies
Agree what you will do if a condom breaks or contraception is missed, including contacting your team quickly about emergency options that are safe after breast cancer.
Review as plans change
If treatment ends, menopause is confirmed or you decide to try for a baby, revisit your contraception choice together with your doctors.
Support each other
Contraception after cancer can feel like one more burden. Sharing the planning and reminders makes it easier for both of you.
Ask together
Bring your partner to a contraception appointment if you both have questions.
Share decisions
Condom use, vasectomy or future family plans are best decided together.
Commonly believed
What people assume about contraception on hormone therapy
Tamoxifen works as contraception.
Tamoxifen does not prevent pregnancy and can harm a baby.
No periods means no need for contraception.
Pregnancy can still happen; use reliable contraception.
Any contraceptive pill is fine after breast cancer.
Hormonal pills are generally avoided.
A copper coil causes cancer.
Copper coils do not cause breast cancer.
Questions we are asked
Common questions about contraception on hormone therapy
How long should I use contraception after stopping tamoxifen?
Usually for about two to three months, or as your team advises.
Is the copper coil safe with tamoxifen?
Yes, it is a common hormone-free choice.
Can I use the hormonal coil?
It is usually avoided; discuss with a specialist.
Do I need contraception on ovarian suppression?
Yes, non-hormonal contraception is still advised.
What emergency contraception is suitable?
A copper coil is effective; ask your team promptly.
What if I get pregnant on tamoxifen?
Contact your oncologist immediately.
Is vasectomy an option for my partner?
Yes, for couples who are sure their family is complete.
Who can fit a copper coil?
A gynaecologist or trained family planning professional.
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Sources
- Faculty of Sexual and Reproductive Healthcare — UK medical eligibility criteria for contraceptive use
- World Health Organization — Medical eligibility criteria for contraceptive use
- National Cancer Institute — Tamoxifen citrate
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.