See literature. Do gynecological exam at least annually. DCIS and risk reduction: consider increased risk of uterine cancer (endometrial adenocarcinoma, uterine sarcoma) and thrombotic events. Women with advanced disease: discontinue if severe hypercalcemia occurs. Monitor blood, lipids, liver function, for thromboembolism symptoms (eg, leg swelling, unexplained shortness of breath), and for uterine changes/cancer (eg, pelvic pain or pressure); promptly investigate any abnormal vaginal bleeding. Breast cancer treatment: history of thromboembolic events. Premenopausal: use effective non-hormonal contraception during and within 2 months of discontinuing therapy; begin therapy during menses or, if irregular menses, obtain (–) B-hCG pregnancy test first.
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Taking tamoxifen while pregnant may be harmful to a developing baby. It’s possible to become pregnant while taking tamoxifen, even if your periods have become irregular or stopped. This means that if you are sexually active with a man your specialist is likely to advise using a non-hormonal method of contraception such as condoms, Femidoms or a diaphragm while you’re taking tamoxifen and for two months after treatment has finished. It may also be possible to use a coil (IUD or intrauterine device). However, you would need to discuss this with your specialist as not all types are suitable for women with breast cancer. If you think you may be pregnant, tell your specialist as soon as possible.