La salud reproductiva y el cáncer de vejiga

The American Cancer Society estimates that over 20,000 women in the United States will be diagnosed with bladder cancer in 2024. While bladder cancer is less common in women than in men, women are more likely to have advanced stages and lower survival rates. As your bladder is close to your reproductive organs, you may wonder how they could be affected if you have bladder cancer. HealthyWomen spoke with experts to answer the most frequently asked questions about what care you should take if you have bladder cancer to protect your reproductive health. Dr. Lee A. Richter is a certified urologist and adjunct professor of urology, obstetrics, and gynecology at the Georgetown University School of Medicine. Melissa Donohue, DSW, is a licensed clinical social worker and certified sex therapist. Can bladder cancer spread to my reproductive organs? If you have bladder cancer, it means that there are cancer cells in your bladder. Most of the time, the cancer stays within the bladder, but in some instances, it may spread within or outside the muscle. This is known as invasive bladder cancer. While rare, it is possible for this cancer to spread to your reproductive organs. Does going through menopause increase my risk of bladder cancer? There is evidence suggesting that the risk of bladder cancer may increase when menopause occurs at an early age, but these data are not solid enough to confirm it. There is also not enough evidence to prove that hormones, such as estrogen, cause bladder cancer. However, your chances of having bladder cancer increase with age. Menopause is a hormonal change, so even though there is not enough evidence to know if menopause increases the risk, postmenopausal people have a higher risk of bladder cancer compared to premenopausal individuals. Can perimenopause or menopause make it harder to get a diagnosis? Blood in the urine is a significant symptom of bladder cancer. So if you are going through perimenopause and still have menstrual periods, it could be difficult to determine the source of the blood. Going through menopause also increases your risk of UTIs (due to lower estrogen levels) and UTIs are another reason that could explain blood in your urine. Your healthcare provider (HCP) may want to ensure that the blood is not from one of these other causes before testing for cancer. But while your healthcare provider follows their protocols for evaluating blood in the urine, bladder cancer could spread and advance by the time it is detected. If you are tested for UTIs and receive negative results, it is important to follow up with your healthcare provider to see what is causing blood in your urine. Bladder cancer and UTIs can also occur simultaneously, so if you are diagnosed with a UTI and suspect that something else is wrong, it is acceptable to request further testing. Can I continue taking contraceptives during bladder cancer treatment? You can continue using hormonal and non-hormonal contraceptives even if you have bladder cancer. Bladder cancer does not use hormones to grow and spread, so hormonal contraceptives, such as the pill or intrauterine devices (IUDs), can be safely used. Non-hormonal contraceptive methods, such as the copper IUD, spermicides, and condoms are also safe. Will my menstrual period be suppressed by bladder cancer treatment? If you have surgery for bladder cancer that removes the uterus, fallopian tubes, and ovaries, this could cause you to have an early menopause and stop having menstrual periods. Some chemotherapy medications can also cause a temporary suspension of your menstrual period. Will my fertility be affected by bladder cancer treatment? Since bladder cancer infrequently affects reproductive organs, bladder cancer treatment usually does not involve the removal of the uterus or ovaries. There is a procedure called genital-preserving cystectomy, which removes the bladder but leaves the uterus and ovaries in place. There is a type of therapy known as neoadjuvant chemotherapy that is chemotherapy provided before a cystectomy surgery to reduce and control the size and spread of cancer before the surgeon removes the cancer and bladder. If you have this type of chemotherapy, you will not be able to become pregnant in the future and you may develop menopausal symptoms such as hot flashes and vaginal dryness. How can bladder cancer treatment affect my sex life? Chemotherapy can cause vaginal dryness, which can lead to irritation. It can also cause mouth sores, which could make kissing and intimacy more difficult. You may also feel nausea or fatigue, which could make it difficult to desire sexual intercourse. Bladder surgery could also require the use of an ostomy bag that collects urine outside of your body. For some people, this may cause insecurity with their partner. Sometimes, part of the vagina may need to be removed, which can make the vaginal canal shorter or narrower, making sexual intercourse uncomfortable, more difficult, or in some cases, impossible. Communication, patience, and compassion are key elements for all couples. It may be helpful to establish new patterns, find your new normal, and redefine what sex is for you and your partner. Resources Bladder Cancer Advocacy Network This educational resource was prepared with the support of Astellas and Pfizer.