Uterine Cancers On the Rise

In perimenoapsue and menopause taking estrogen can cause wide ranging side effects. However, the effects on the lining of the uterus is not one of the benefits. Estrogen can cause bleeding, spotting, polyps, precancer and even lining cancer of the uterus. 

In a new report we have found that rates of uterine cancers are going up. 

In a study, published May 22, 2019 in the Journal of Clinical Oncology the information from NCI’s Surveillance, Epidemiology, and End Results (SEER) database to evaluate trends in uterine cancer incidence rates for women overall and by race and ethnicity, geographic region, and biologic subtype , and found more aggressive and what used to be rare types of cancers of the uterus are increasing. 

Whether these things will occur will depend on many factors, including lifestyle, prior therapy, your diet, and your genetics. 

In the study it was thought that the biggest increases in uterine cancer, were due to cancers that are caused due to obesity. 

However, we still want to point out to women that we know that for the uterus the treatment with estrogen alone increases the risk of endometrial hyperplasia (lining thickening) and endometrial carcinoma (uterine lining cancer) by many times. In some studies the risks of thickening were doubled and the risk of lining cancers rose from 1/000 to 1/1000.  And further good news is that cancers which appear this way seem to be more treatable and less aggressive.

There is a protected effect of progesterone therapy. Exactly the type and timing of the progesterone therapy would be up to your gyno, and many factors have to be considered. Even the progesterone IUDs may work for some women’s endometrial protection, so if you have one as you enter menopause, you may be covered. Months of estrogen therapy is less likely to produce harm than years, and thus a period of adjustment with one hormone verses the double hormone is possible. 

There really is no other menopausal benefit to progesterone therapy, it is only used for this lining protection, and women without a uterus have no need for the progesterone therapy. Many studies show progesterone therapy with the estrogen is what raises the breast cancer risk, so there is a lot to gab about with your gyno, but generally this ‘unopposed’ estrogen therapy (estrogen with no progesterone) is not recommended. 

Lifestyle factors can combat the obesity that is responsible for these alarming trends in uterine cancer rates. 

Not all growths of the uterus are cancerous, and many can be treated with simple therapies. A polyp hanging out of your cervix may be from the cervix, or actually from the lining of the uterus. Endocervical polyps are not likely to be an effect of estrogen, usually the estrogen causes lining polyps which wouldn’t be seen on an exam, but require an ultrasound to be seen. Cone in to discuss with your gyno if you still have questions.