The Endometrium & Uterine Cancer
What Is The Endometrium?
The endometrium (en-doh-MEE-tree-um) is the tissue lining the inside of the uterus. The uterus also has an outer muscular layer called the myometrium. Hormones cause the endometrium to grow and, during many menstrual cycles, shed as a period. [NCI]
Uterine Cancer Vs. Endometrial Cancer
Uterine cancer is a broad term for cancer that begins in the uterus. Endometrial cancer begins in the endometrium and is the most common type of uterine cancer. Uterine sarcoma begins in the muscle or supporting tissues and is different. [CDC; NCI]
Risk Factors
Risk can be higher with older age; obesity; metabolic syndrome or type 2 diabetes; long-term estrogen exposure without enough progesterone; estrogen-only hormone therapy in a person who still has a uterus; tamoxifen use; endometrial hyperplasia; PCOS; never having been pregnant; early first period or later menopause; a first-degree family history; and inherited conditions such as Lynch syndrome. Risk factors do not equal a diagnosis. [NCI]
Early Detection And Diagnosis
There is no standard routine screening test for average-risk people without symptoms. A Pap test screens for cervical cancer and generally does not detect endometrial cancer. Report abnormal bleeding promptly. Evaluation may include medical history, pelvic examination, transvaginal ultrasound, hysteroscopy, and an endometrial biopsy or dilation and curettage (D&C). Tissue examined under a microscope confirms the diagnosis. [NCI; CDC]
Treatment
Treatment is individualized by cancer type, grade, molecular features, stage, overall health, and personal priorities. Surgery—often hysterectomy with removal of the fallopian tubes and ovaries—is standard for many early-stage cases. Depending on risk and stage, care may also include radiation, chemotherapy, hormone therapy, immunotherapy, targeted therapy, or a clinical trial. Ask whether the tumor will be tested for mismatch repair, microsatellite instability, and other molecular markers, and whether genetic counseling is appropriate. NCCN patient guidelines explain the treatment pathway in detail. [NCI; NCCN]
When To Act
Contact a health care professional promptly for any postmenopausal bleeding or new, unusual vaginal bleeding or discharge. Seek urgent care for very heavy bleeding (such as soaking pads rapidly), fainting, chest pain, shortness of breath, severe weakness, or severe/worsening pain.
Know The Signs
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Any vaginal bleeding or spotting after menopause
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Bleeding or discharge that is unusual for you, including bleeding between periods
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Periods that become unusually heavy, prolonged, or irregular
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Pelvic pain or pressure
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Pain during sex or difficult/painful urination
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These symptoms can have noncancerous causes, but they deserve medical evaluation. Do not wait for pain: abnormal bleeding is often the first warning sign. [CDC; NCI]
Do not ignore postmenopausal bleeding. Even a small amount should be reported promptly to a healthcare professional.
Verified Health Information Sources
The information provided by She Thrives Foundation is for general education and awareness only. It is not intended to diagnose a condition, recommend treatment, or replace advice from a licensed healthcare professional. Always speak with a qualified healthcare professional about symptoms, risk factors, screening, diagnosis, and treatment. If you are experiencing severe bleeding, fainting, chest pain, shortness of breath, severe weakness, or severe or worsening pain, seek immediate medical care.