Signs of Endometrial Cancer

Postmenopausal bleeding should always be evaluated by your provider

As women age and approach menopause, changes in menstruation can occur, like unusually heavy periods or spotting between them. But don’t ignore these seemingly harmless symptoms, as they can point to a more serious issue.

Abnormal bleeding could be a sign of endometrial cancer, sometimes referred to as uterine cancer. It’s the most common cancer affecting the female reproductive system.

Thankfully, because endometrial cancer may cause symptoms early on, doctors often detect it at earlier stages and start effective treatment right away to improve outcomes.

“Being proactive is the first step in protecting your health,” says Sarah Podwika, MD, a gynecologic oncologist at Geisinger. “Annual checkups, knowing your personal risk factors and talking to your provider about symptoms or changes in your health are key to catching endometrial cancer early.”

What is endometrial cancer?

Endometrial cancer develops when abnormal cells begin to grow uncontrollably in the endometrium, or the inner lining of the uterus. These cells may form a mass, or tumor, and can spread to other parts of the body if left untreated.

“The good news is the most common type of endometrial cancer is endometrioid, which usually grows slowly and is found before it has a chance to spread,” says Dr. Podwika. “There are less common, but more aggressive types as well.”

Signs of endometrial cancer

The telltale sign of endometrial cancer is irregular vaginal bleeding. This might include bleeding or spotting between periods, longer or unusually heavy periods, or vaginal bleeding or dark discharge after menopause.

“If you have bleeding after menopause, talk to your provider right away,” says Dr. Podwika. “That’s not normal. Periods don’t suddenly start up again years after they’ve stopped.”

She also advises you to talk to your provider if you’re still getting a period or having irregular ones after the typical age of onset for menopause, which is 51 to 52 years old.

More advanced signs of endometrial cancer can include:

Pelvic pain or discomfort
Unexplained weight loss
Changes in bladder or bowel habits

“Abnormal bleeding can be caused by other gynecological conditions and doesn’t necessarily indicate cancer,” says Dr. Podwika. “But it’s still important to report these symptoms to your provider to rule out more serious conditions. It’s better to err on the side of safety.”

Endometrial cancer risk factors

The risk of endometrial cancer increases with age and is most often diagnosed in postmenopausal women.

“Many risk factors relate to hormonal imbalances,” says Dr. Podwika. “Changes in the balance of estrogen and progesterone can cause changes to the endometrium, which can become too thick and increase the risk of cancer.”

Obesity, Type 2 diabetes and PCOS (polycystic ovary syndrome) are risk factors because these conditions can increase estrogen levels, but not progesterone.

Other endometrial cancer risk factors include:

Family history of endometrial cancer
Irregular menstrual cycles
Hormone therapy for breast cancer
Certain genetic disorders like Lynch syndrome
Starting menstruation early or menopause late
Never being pregnant

“Understanding your risk factors can help in recognizing symptoms early on,” says Dr. Podwika.

When to talk to your doctor about abnormal vaginal bleeding

Since there is no routine screening for endometrial cancer, reporting symptoms like abnormal bleeding to your provider right away — especially if symptoms are new or worsening — is key to detecting it early.

“That’s why it’s so important to listen to your body for warning signs, have regular checkups and maintain ongoing dialogues with your provider about your personal risk factors,” says Dr. Podwika. “Because when caught early, endometrial cancer is a highly treatable and curable disease.”