For the body to start puberty, it needs ovaries and testicles that work and that are capable of producing hormones. This may be temporarily or permanently damaged by cancer therapy (chemotherapy and radiotherapy). But even if the ovaries and testicles could actually work, the body carefully considers whether it can actually manage to go through puberty. In particular for females, that means whether the female body could theoretically cope with a pregnancy. Therefore, it could be that the body is still too weakened by the therapy and the disease to start puberty. So puberty could well start later and perhaps take longer than what your friends are experiencing. This is particularly the case if you were diagnosed with cancer just before or during puberty. Depending on the situation, you can usually wait until the body has completely recovered and starts producing hormones itself. But puberty should have started for girls at the latest by the time they are 14 and for boys by the time they are 15 to prevent hormone deficiency and above all to protect your bones. But the waiting can be a burden for you, so feel free to talk to a specialist about how long you should wait.
If your ovaries stop working temporarily or even long term, it may be important to help you get through puberty. If the ovaries don’t produce hormones even after this, it may also be necessary to replace the hormones permanently. These hormones are very similar to the body’s own and you won’t suffer any disadvantages because the body is getting what it needs. But it could be that you experience puberty in a slightly different way from your friends. During natural puberty, the ovaries first have to get used to working and so you will experience hormonal fluctuations, increased levels of male hormones will sometimes cause acne or severe mood changes, and you could suffer from irregular or very heavy periods. If you have to take hormones on a regular basis, puberty will take on a more uniform progression. It could well be that you develop a bust and also pubic hair more slowly than others, although this is not always the case. But it is important to know that, long term, there are no physical or health disadvantages for you if you need to take hormones.
Hormone replacement therapy ( = HRT) is, as the name suggests, about replacing hormones the body can no longer produce. This is particularly the case with a premature malfunctioning of the ovaries. If an ovary has been damaged to such an extent that it is no longer able to produce hormones, the hormones have to be replaced – oestrogen in particular as it is very important for both the growth and the density of your bones, as well as for your blood vessels. Normally, the ovaries stop producing hormones at some point over the age of 45. If this happens beforehand, however, it is important to replace the missing hormones so that there is no damage to your bones or blood vessels. They are replaced in the form of tablets, patches or a gel for on your skin. These hormones are very similar to the body’s own, but they don’t work as a contraceptive. So in terms of birth control and in the case of a few remaining egg cells, you must use a condom or take the pill as a form of contraception. A doctor should clarify whether this is necessary in your particular case. Health insurance companies cover the costs of HRT. Hormone replacement therapy gives you the choice of having your period suppressed completely or still having a normal monthly cycle. This is also something that should be decided on a case by case basis with an expert.