Endometrial cancer (EC) primarily affects women who are past menopause. The average age of diagnosis is 60, and this type of cancer is uncommon in women under the age of 45.
But why does this disease so often emerge after a woman’s reproductive years have ended? The answer involves the complex interplay of hormones, genetics and aging.
Hormonal shifts after menopause
The endometrium, or lining of the uterus, is mainly regulated by two hormones: estrogen and progesterone. During reproductive years, these hormones rise and fall in a cycle that prepares the uterus for pregnancy. Progesterone balances estrogen’s stimulating effect on the endometrium by helping shed the lining during menstruation.
After menopause, progesterone production falls sharply. Estrogen also drops but is still present, especially in women with higher body fat, since fat tissue can produce estrogen. Without progesterone’s balancing effect, this “unopposed estrogen” can cause the endometrium to thicken abnormally, which over time increases the risk of cancer.
Age and genetics
Cancer risk naturally increases with age. Over time, cells accumulate genetic mutations, or small errors in DNA replication or repair. Many of these mutations are harmless, but some can interfere with normal cell growth. When these changes occur in the endometrial lining, they can set the stage for EC to develop.
Certain inherited conditions, such as Lynch syndrome, can also significantly raise cancer risk. Lynch syndrome is caused by a genetic defect that increases the likelihood of many types of cancer, including EC. Individuals with this condition are often counseled to undergo increased preventive screening to detect cancers early or prevent them.
Read more about endometrial cancer FAQs
Weight and lifestyle factors
Obesity is one of the most significant risk factors for EC in postmenopausal women. Extra fat tissue not only produces estrogen, but also contributes to chronic inflammation, which can damage cells and create an environment where cancer is more likely to thrive.
Type 2 diabetes and high blood pressure, two conditions that are more common with age, are also risk factors for EC.
Warning signs and awareness for postmenopausal women
Fortunately, in many cases, EC shows symptoms early so it is often detected at earlier stages.
Symptoms of EC postmenopausal women should be aware of include:
- Vaginal bleeding or spotting after menopause.
- Lower abdominal pain or cramping.
- White or clear vaginal discharge after menopause.
If you experience any of these symptoms, talk to your doctor. The earlier EC is caught, the better the treatment outcome.
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