Medical Oncologist
Medicines
Sacituzumab govitecan, fertility, menopause and sexual health
Sacituzumab govitecan carries chemotherapy, so it may reduce fertility, change periods and bring on menopause in some women. It can harm an unborn baby, so reliable contraception is needed during and after treatment. This page explains the general advice and offers practical help with sex, intimacy and difficult conversations.
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
- How does sacituzumab govitecan affect fertility, menopause and sex?
- The main ways treatment can affect you
- Contraception and breastfeeding at a glance
- The vocabulary, in plain language
- What is known and what is not
- Sex and closeness during treatment
- Raising these topics with your team and partner
- Menopause, bones and wellbeing over time
- What people assume about fertility and sex
- Common questions about fertility, menopause and sex
The short answer
How does sacituzumab govitecan affect fertility, menopause and sex?
Sacituzumab govitecan carries a chemotherapy drug, and like other chemotherapy it can affect the ovaries, a developing baby and your sexual wellbeing. Studies of fertility in people are limited, but animal studies and experience with similar chemotherapy suggest it may reduce fertility in women. In premenopausal women, periods may become irregular or stop during treatment. For some they return afterwards, while others, especially those who are older or have had several earlier chemotherapy treatments, may go through menopause. Because the medicine can harm an unborn baby, pregnancy must be avoided. The official label advises women who could become pregnant to use effective contraception during treatment and for six months after the last dose, and men with a partner who could become pregnant to use contraception during treatment and for three months after. Breastfeeding is not advised during treatment and for one month after. Sexual wellbeing can be affected in many ways: tiredness, loose motions, feeling sick, hair loss, low mood, vaginal dryness and worry about the future all play a part. Most of these can be eased with practical steps and support. As sacituzumab govitecan is used for metastatic breast cancer, conversations about having children are often complex and personal, and your oncologist can talk them through honestly with you and your partner.
Avoid pregnancy
Use reliable contraception during and for the advised time after treatment.
Periods may change
They can stop during treatment, and may or may not return.
Intimacy is still possible
Closeness and sex are usually safe, with a few sensible precautions.
This page gives general information only. Discuss your own situation with your oncologist.Areas affected
The main ways treatment can affect you
Every person's experience is different, and many changes can be helped.
Fertility
The chemotherapy part may damage eggs and reduce the chance of pregnancy later, particularly with age and earlier chemotherapy.
Periods and menopause
Periods may stop. Menopause symptoms such as hot flushes, night sweats and vaginal dryness can follow.
No periods does not mean you cannot conceive.Pregnancy
The medicine can harm a developing baby, so contraception is essential during and after treatment.
Sexual wellbeing
Desire and comfort can drop for physical and emotional reasons.
Common contributors
- Tiredness and loose motions
- Hair loss and body image worries
- Vaginal dryness and low mood
Precautions
Contraception and breastfeeding at a glance
Who
General label advice
Women who could become pregnant
Effective contraception during treatment and for six months after the last dose
Men with a partner who could become pregnant
Contraception during treatment and for three months after the last dose
Breastfeeding
Not during treatment and for one month after the last dose
Before starting
A pregnancy test for women who could be pregnant
Hormonal contraception
Often avoided in breast cancer, so ask about non-hormonal options
Words you will hear
The vocabulary, in plain language
- Ovarian reserve
- The number of eggs left in the ovaries, which falls with age and chemotherapy.
- Chemotherapy-induced menopause
- Menopause brought on by treatment rather than by natural ageing.
- Copper IUD
- A non-hormonal device placed in the womb to prevent pregnancy.
- Egg or embryo freezing
- Storing eggs or embryos for possible future use.
- Vaginal moisturiser
- A non-hormonal product used regularly to ease dryness.
- Lubricant
- A gel used during sex to reduce friction and discomfort.
Being straight with you
What is known and what is not
There is little research on fertility after this specific medicine, so advice draws on animal studies and on chemotherapy more broadly.
Fertility effects are hard to predict
Age, earlier treatments and your starting egg reserve all matter.
Pregnancy decisions are complex in metastatic disease
Your oncologist can discuss honestly how pregnancy might affect your health and treatment plans.
Sexual changes are often under-reported
Many people do not mention them, yet help is available.
What this page cannot tell you
It cannot tell you whether your own fertility will be affected. A fertility specialist can assess this.
Talk to our team
Have a question about your situation?
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Intimacy
Sex and closeness during treatment
Many couples wonder whether sex is allowed during chemotherapy. For most people it is, with a few precautions.
Protect your partner
Small amounts of chemotherapy may be present in body fluids for a few days after each dose. Many teams advise using condoms during this time.
Take care when counts are low
Infection risk is higher when your white cell count is low. Good hygiene and avoiding sex when counts are very low may be advised.
Ease dryness
Water-based lubricants and regular vaginal moisturisers help. Ask before using hormonal creams.
Closeness without sex
Holding hands, massage and time together keep intimacy alive when sex feels too much.
Talking about it
Raising these topics with your team and partner
In many families, sex and fertility are hard to talk about. Yet these conversations often bring relief.
With your oncology team
Write your questions down beforehand. You can ask to speak without family present if that feels easier.
With your partner
Share how you feel physically and emotionally, and agree on what feels comfortable for now.
Specialist help
Counsellors, psycho-oncologists and sexual health specialists can support individuals and couples.
Longer term
Menopause, bones and wellbeing over time
If treatment brings on menopause, some effects build slowly and are easy to overlook while the focus is on the cancer.
Bone health
Lower oestrogen can thin the bones over time. Your team may suggest calcium, vitamin D, weight-bearing activity or a bone density scan.
Mood and sleep
Night sweats, broken sleep and worry can affect mood. Tell your team if low mood lasts, as counselling and some medicines can help.
Body image
Hair loss, weight change and scars can change how you see yourself. Talking with others who have been through treatment often helps.
Commonly believed
What people assume about fertility and sex
If my periods stop, I cannot get pregnant.
Pregnancy is still possible, so contraception is needed.
Sex can spread cancer to my partner.
Cancer is not passed on through sex.
Loss of desire means something is wrong with the relationship.
Treatment, tiredness and worry commonly lower desire for a while.
Contraception can stop once treatment ends.
It should continue for the advised time after the last dose.
Questions we are asked
Common questions about fertility, menopause and sex
Which contraception is best?
Non-hormonal methods are usually preferred in breast cancer, because hormonal contraception may not be advised. Condoms and the copper coil are common choices. Your oncologist or a gynaecologist can help you choose a method that is reliable, suits your health and fits your relationship.
Will my periods come back?
It depends mainly on your age, earlier treatments and how many eggs remain. Younger women are more likely to see periods return, sometimes months after treatment ends. Older women or those who have had several chemotherapy treatments may enter menopause. Your team can arrange hormone blood tests if helpful.
Can I freeze eggs before starting?
It may be possible, but it takes time and involves hormone stimulation, which must be weighed against the need to start treatment for metastatic cancer. Special stimulation methods are used in breast cancer. Ask your oncologist early if having children in future is important to you.
What if I become pregnant during treatment?
Tell your oncology team straight away. Treatment is usually paused while your options are discussed. The medicine can harm a developing baby, so your team will explain the risks openly and support you through any decision you make.
How can I cope with hot flushes?
Light cotton clothing, a fan, cool drinks, and avoiding triggers such as spicy food, alcohol and hot drinks can help. Some non-hormonal medicines are used for troublesome flushes. Hormone replacement therapy is usually avoided after breast cancer, so ask your oncologist about safe options.
Is it safe for my partner if we have sex?
Yes, with sensible precautions. Many teams advise condoms for a few days after each dose because tiny amounts of chemotherapy may be in body fluids, and throughout treatment to prevent pregnancy. Cancer itself cannot be passed on. Ask your team what they recommend.
Sex is painful now. What helps?
Dryness is a common cause. Regular vaginal moisturisers, generous water-based lubricant, taking more time and trying different positions can help. If pain continues, a gynaecologist or sexual health specialist can check for other causes, such as infection, and suggest further treatment.
Can men on this medicine father children?
Men should avoid fathering a child during treatment and for three months after the last dose, and use contraception. The medicine may affect sperm. Men who want children in future can ask about sperm banking before treatment starts.
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Speak to a breast cancer specialist
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Sources
- European Medicines Agency — Trodelvy product information
- Macmillan Cancer Support — Sacituzumab govitecan (Trodelvy)
- National Cancer Institute — Fertility issues in girls and women with cancer
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.