Endometrial cancer is a type of uterine cancer that starts in the inner lining of the uterus. This lining is called the endometrium.

According to the National Cancer Institute (NCI), approximately 3 in 100 women will be diagnosed with uterine cancer at some point in their lives. More than 80 percent of people with uterine cancer survive for 5 years or longer after receiving the diagnosis.

If you have endometrial cancer, early diagnosis and treatment increase your chances of remission.

One of the most common symptoms of endometrial cancer is abnormal vaginal bleeding. This can include:

  • changes in the length or heaviness of menstrual periods
  • vaginal bleeding or spotting between menstrual periods
  • vaginal bleeding after menopause

Other potential symptoms of endometrial cancer include:

If you experience any of these symptoms, make an appointment with your doctor. These symptoms aren’t necessarily a sign of serious condition, but it’s important to get them checked out.

Abnormal vaginal bleeding can be caused by menopause or other noncancerous conditions. But in some cases, it’s a sign of endometrial cancer or other types of gynecological cancer.

Your doctor can help you identify the cause of your symptoms and recommend appropriate treatment, if needed.

In most cases, the exact cause of endometrial cancer is unknown. However, experts believe that changes in the level of estrogen and progesterone in the body often play a part.

When the levels of those sex hormones fluctuate, it affects your endometrium. When the balance shifts toward increased levels of estrogen, it causes endometrial cells to divide and multiply.

If certain genetic changes occur in endometrial cells, they become cancer. Those cancer cells rapidly grow and form a tumor.

Scientists are still studying the changes that cause normal endometrial cells to become cancer cells.

The risk of endometrial cancer increases with age. Most cases of endometrial cancer are diagnosed between the ages of 45 and 74 years old, reports the NCI.

Several other risk factors may also raise the risk of endometrial cancer, including:

  • changes in sex hormone levels
  • certain medical conditions
  • family history of cancer
  • living with obesity

Hormone levels

Estrogen and progesterone are female sex hormones that affect the health of your endometrium. If the balance of these hormones shifts towards increased estrogen levels, it can raise your risk of endometrial cancer.

Certain aspects of your medical history can affect your sex hormone levels and risk of endometrial cancer, including:

  • Years of menstruation: The more menstrual periods that you’ve had in your life, the more exposure your body has had to estrogen. If you got your first period before you were 12 years old or you went through menopause late in life, you may be at increased risk of endometrial cancer.
  • History of pregnancy: During pregnancy, the balance of hormones shifts towards progesterone. If you’ve never been pregnant, your chances of developing endometrial cancer are heightened. This is especially true if you were unable to become pregnant due to infertility issues.
  • Polycystic ovarian syndrome (PCOS): In this hormonal disorder, estrogen levels are high and progesterone levels are unusually low. If you have a history of PCOS, your chances of getting endometrial cancer are increased.
  • Granulosa cell tumors: Granulosa cell tumors are a type ofovarian tumor that release estrogen. If you’ve had one of these tumors, it raises your risk of endometrial cancer.

Some types of medication can also change the balance of estrogen and progesterone in your body, including:

  • Estrogen replacement therapy (ERT): ERT is sometimes used to treat symptoms of menopause. Unlike other types of hormone replacement therapy (HRT) that combine estrogen and progesterone (progestin), ERT uses estrogen alone and may increase your risk of endometrial cancer.
  • Tamoxifen: This drug is used to help prevent and treat certain types of breast cancer. It can act like estrogen in your uterus and may increase endometrial cancer risk.
  • Oral contraceptives (birth control pills): Taking birth control pills reduces your risk of endometrial cancer. The longer you take them, the lower your risk of endometrial cancer.
  • Intrauterine device: Using an intrauterine device, otherwise known as an IUD, has also been linked to a lower risk of endometrial cancer.

Medications that raise your risk of endometrial cancer may lower your risk of other conditions. Conversely, drugs that lower your risk of endometrial cancer may raise your risk of some conditions.

Your doctor can help you weigh the potential benefits and risks of taking different medications, including ERT, tamoxifen, or birth control pills.

Endometrial hyperplasia

Endometrial hyperplasia is a noncancerous condition in which your endometrium becomes unusually thick. In some cases, it goes away on its own. In other cases, it may be treated with HRT or surgery.

The type of HRT treatment for endometrial hyperplasia is usually a progesterone-based treatment, since estrogen can fuel the growth of the lining.

If left untreated, endometrial hyperplasia sometimes develops into endometrial cancer.

The most common symptom of endometrial hyperplasia is abnormal vaginal bleeding.


According to the American Cancer Society (ACS), women who live with extra weight (BMI 25 to 29.9) are twice as likely to develop endometrial cancer as women who aren’t. Those living with obesity (BMI > 30) are more than three times as likely to develop this type of cancer.

This might reflect the effects that body fat has on estrogen levels. Fat tissue can convert some other types of hormones (androgens) into estrogen. This can raise the level of estrogen in the body, increasing the risk of endometrial cancer.


Women with type 2 diabetes may be about twice as likely to develop endometrial cancer as those without diabetes, warns the ACS.

However, the nature of this link is uncertain. Type 2 diabetes is more common in people who are living with extra weight or who have obesity, which is also a risk factor for endometrial cancer. The high rate of obesity in people living with type 2 diabetes might account for the increased risk of endometrial cancer.

History of cancer

You may be more likely to develop endometrial cancer if other members of your family have had it.

You’re also at increased risk of endometrial cancer if you have a family history of Lynch syndrome. This condition is caused by mutations in one or more of the genes that repair certain mistakes in cell development.

If you have the genetic mutations associated with Lynch syndrome, it slightly increases your risk of certain types of cancer, including colon cancer and endometrial cancer. According to a 2019 meta-analysis, Lynch syndrome was found in about 3 percent of those already living with endometrial cancer.

If you’ve had breast cancer or ovarian cancer in the past, that may also raise your risk of endometrial cancer. Some of the risk factors for these cancers are the same. Radiation therapy on your pelvis can also heighten your chances of developing endometrial cancer.

What to know about risk factors

While these risk factors can feel extensive, many individuals with certain risk factors never develop endometrial cancer, and some individuals without any risk factors can develop it.

Getting regular checkups, and addressing health changes with a doctor right away, are two of the best methods to protect yourself against endometrial cancer.

Over time, endometrial cancer can potentially spread from the uterus to other parts of the body.

The cancer is classified into four stages based on how much it has grown or spread:

  • Stage 1: The cancer is only present in the uterus.
  • Stage 2: The cancer is present in the uterus and cervix.
  • Stage 3: The cancer has spread outside the uterus, but not as far as the rectum or bladder. It might be present in the fallopian tubes, ovaries, vagina, and/or nearby lymph nodes.
  • Stage 4: The cancer has spread beyond the pelvic area. It might be present in the bladder, rectum, and/or distant tissues and organs.

When a person is diagnosed with endometrial cancer, the stage of the cancer affects what treatment options are available and the long-term outlook. Endometrial cancer is easier to treat in the early stages of the condition.

If you develop symptoms that might be endometrial cancer, make an appointment with your primary care doctor or gynecologist.

Your doctor will ask you about your symptoms and medical history. They will perform a pelvic exam to look and feel for abnormalities in your uterus and other reproductive organs. To check for tumors or other abnormalities, they may order a transvaginal ultrasound exam.

An ultrasound exam is a type of imaging test using sound waves to create pictures of the inside of your body. To perform a transvaginal ultrasound, your doctor or other healthcare professional will insert an ultrasound probe into your vagina. This probe will transmit images onto a monitor.

If your doctor detects abnormalities during the ultrasound exam, they may order one or more of the following tests to collect a sample of tissue for testing:

  • Endometrial biopsy: In this test, your doctor inserts a thin flexible tube through your cervix into your uterus. They apply suction to remove a small piece of tissue from your endometrium through the tube.
  • Hysteroscopy: In this procedure, your doctor inserts a thin flexible tube with a fiber-optic camera through your cervix into your uterus. They use this endoscope to visually examine your endometrium and biopsy samples of abnormalities.
  • Dilation and curettage (D&C): If the results of a biopsy are unclear, your doctor might collect another sample of endometrial tissue using D&C. To do so, they dilate your cervix and use a special tool to scrape tissue from your endometrium.

After collecting a sample of tissue from your endometrium, your doctor will send it to a lab for testing.

If you have endometrial cancer, your doctor will likely order additional tests to learn if the cancer has spread. For example, they might order blood tests, X-ray tests, or other imaging tests.

The ACS reports that most cases of endometrial cancer are adenocarcinomas, which are cancers that develop from glandular tissue.

Less common forms of endometrial cancer include:

  • uterine carcinosarcoma (CS)
  • squamous cell carcinoma
  • small cell carcinoma
  • transitional carcinoma
  • serous carcinoma

The different kinds of endometrial cancer are classified into two main types:

  • Type 1 tends to be relatively slow-growing, and doesn’t spread quickly to other tissues.
  • Type 2 tends to be more aggressive and is more likely to spread outside the uterus.

Type 1 endometrial cancers are more common than type 2. They are also easier to treat.

There are several treatment options available for endometrial cancer. Your doctor’s recommended treatment plan will depend on the subtype and stage of the cancer, as well as your overall health and personal preferences.

There are potential benefits and risks associated with each treatment option. Your doctor can help you understand the potential benefits and risks of each approach.


Endometrial cancer is often treated with a type of surgery known as hysterectomy.

During a hysterectomy, a surgeon removes the uterus. They might also remove the ovaries and fallopian tubes, in a procedure known as a bilateral salpingo-oophorectomy (BSO). Hysterectomy and BSO are typically performed during the same operation.

To learn if the cancer has spread, the surgeon will also remove nearby lymph nodes. This is known as lymph node dissection or lymphadenectomy.

If the cancer has spread to other areas of the body, the surgeon might recommend additional surgeries.

Radiation therapy

Radiation therapy uses high-energy beams to kill cancer cells.

There are two main types of radiation therapy used to treat endometrial cancer:

  • External beam radiation therapy: An external machine focuses beams of radiation on the uterus from outside your body.
  • Internal radiation therapy: Radioactive materials are placed inside the body, in the vagina or uterus. This is also known as brachytherapy.

Your doctor might recommend one or both types of radiation therapy after surgery. This can help kill cancer cells that might remain after surgery.

In rare cases, they might recommend radiation therapy before surgery. This can help shrink tumors to make them easier to remove.

If you can’t have surgery due to other medical conditions or poor overall health, your doctor might recommend radiation therapy as your main treatment.


Chemotherapy involves the use of drugs to kill cancer cells. Some types of chemotherapy treatment involve one drug, while others involve a combination of drugs. Depending on the type of chemotherapy that you receive, the drugs might be in pill form or given through an intravenous (IV).

Your doctor might recommend chemotherapy for endometrial cancer that has either spread to other parts of the body, or has returned after past treatment.

Targeted therapy and immunotherapy

A fairly new way to treat endometrial cancer involves targeted therapy, which is treatment with drugs that are made to target certain changes in the cancer cells. Only a few of these targeted therapy drugs are currently available, as many are still being studied in clinical trials.

Immunotherapy is another more individualized approach, and involves treatment with drugs that help your immune system recognize and kill cancer cells.

Occasionally, targeted therapies and immunotherapy are used in conjunction with one another, or with chemotherapy.

Hormone therapy

Hormone therapy involves the use of hormones or hormone-blocking drugs to change the body’s hormone levels. This can help slow the growth of endometrial cancer cells.

Your doctor might recommend hormone therapy for stage III or stage IV endometrial cancer. They might also recommend it for endometrial cancer that has returned after treatment.

Hormone therapy is often combined with chemotherapy.

Emotional support

If you’re having trouble coping emotionally with your cancer diagnosis or treatment, let your doctor know. It’s common for people to have difficulty managing the emotional and mental effects of living with cancer.

Your doctor may refer you to an in-person or online support group for people with cancer. You might find it comforting to connect with others who are going through similar experiences.

Your doctor might also refer you to a mental health specialist for counseling. One-on-one or group therapy might help you manage the psychological and social effects of living with cancer.

Some strategies may help you lower your risk of developing endometrial cancer:

  • Lose weight: If your doctor has recommended it, losing weight and maintaining that weight loss can lower your risk of endometrial cancer, and can also lower your risk of any type of cancer returning.
  • Get regular exercise: Regular physical activity has been linked to a lower risk of endometrial cancer.
  • Seek treatment for abnormal vaginal bleeding: If you develop abnormal vaginal bleeding, make an appointment with your doctor. If the bleeding is caused by endometrial hyperplasia, ask your doctor about treatment options.
  • Consider the pros and cons of hormone therapy: If you’re thinking about using HRT, ask your doctor about the potential benefits and risks of using estrogen alone versus a combination of estrogen and progesterone (progestin).
  • Ask your doctor about the potential benefits of contraceptives: Birth control pills and intrauterine devices (IUDs) have been linked to reduced risk of endometrial cancer. Your doctor can help you learn about the potential benefits and risks of using these contraceptives.
  • Let your doctor know if you have a history of Lynch syndrome: If your family has a history of Lynch syndrome, your doctor might recommend genetic testing. If you have Lynch syndrome, they might encourage you to consider having your uterus, ovaries, and fallopian tubes removed to prevent cancer from developing in those organs.
  • Monitor your family history for cancer: If you’ve noticed that your family history includes clusters of certain type of cancers (such as ovarian or colon cancer), ask your doctor if genetic testing is a good idea.

If you have symptoms that could be a sign of endometrial cancer or another gynecological condition, make an appointment with your doctor. Experiencing abnormal vaginal bleeding is usually the main symptom of endometrial cancer, but this could be a sign of more benign health conditions as well.

It’s always better to address changes in your health sooner rather than later, because when it comes to many cancers, like endometrial cancer, early diagnosis and treatment may help improve your long-term outlook.