Endometrial Cancer: Symptoms, Diagnosis, Treatment and Support
Updated: 4 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is endometrial cancer?
Endometrial cancer begins in the lining of the uterus, called the endometrium. Irregular vaginal bleeding, especially bleeding after menopause or between periods, is often the first symptom. Diagnosis may include a pelvic exam, imaging, hysteroscopy and a biopsy, while treatment depends on the cancer’s characteristics, stage, general health and preferences. [4]
What the research says
Postmenopausal bleeding is very common in endometrial cancer, but most bleeding is not cancer. A meta-analysis of 129 studies (40,790 women) found that 91% of women with endometrial cancer had postmenopausal bleeding (95% CI 87% to 93%), regardless of tumor stage. Among women with postmenopausal bleeding, the pooled risk of endometrial cancer was 9% (95% CI 8% to 11%), so most women with this symptom are not diagnosed with the disease, but the symptom still needs assessment (Clarke et al., JAMA Intern Med, 2018). [1]
Higher body weight is linked to higher endometrial cancer risk, even within the high-normal BMI range. In a meta-analysis of 30 prospective studies (22,320 cases among 6,445,402 participants), each 5-unit increase in body mass index was associated with a 54% higher risk (summary relative risk 1.54, 95% CI 1.47 to 1.61). The curve was steeper in the overweight and obese ranges. These are observational findings, so they show association rather than proof of cause (Aune et al., Ann Oncol, 2015). [2]
Among women who already have endometrial cancer, higher BMI is linked to higher all-cause mortality. A systematic review and meta-analysis of 18 studies found that women with a BMI of 40 or more had higher odds of all-cause death than women with a BMI below 25 (odds ratio 1.66, 95% CI 1.10 to 2.51) (Secord et al., Gynecol Oncol, 2016). [3]
What is endometrial cancer?
Endometrial cancer is a type of cancer that begins in the lining of the uterus, called the endometrium. The uterus is a hollow, pear-shaped organ in the pelvis where fetal development occurs. [4]
Endometrial cancer is sometimes called uterine cancer. However, other types of cancer can form in the uterus, including uterine sarcoma. These are different conditions. [4]
Endometrial cancer is often found at an early stage because it can cause symptoms, particularly unusual vaginal bleeding. When it is found early, surgery to remove the uterus often cures it. [4]
Endometrial cancer at a glance
Topic | Key information |
Definition | Cancer that begins in the lining of the uterus, called the endometrium. |
Common warning sign | Irregular vaginal bleeding, including bleeding after menopause or between periods. |
Other symptom | Pelvic pain. |
Risk factors | Hormone imbalance, older age, obesity, never having been pregnant, more years of menstruation, tamoxifen and Lynch syndrome. |
Diagnosis | Pelvic exam, imaging, hysteroscopy, biopsy and sometimes dilation and curettage. |
Stages | Stages 1 through 4, based on how far the cancer has grown or spread. |
Treatment | May include surgery, radiation, chemotherapy, hormone therapy, targeted therapy, immunotherapy and palliative care. |
Next step | Arrange professional assessment for unusual bleeding, pelvic pain or other worrying symptoms. |
What symptoms can endometrial cancer cause?
The main symptoms are:
Vaginal bleeding after menopause.
Bleeding between periods.
Pelvic pain.
Unusual bleeding can have causes other than cancer. An online article cannot determine the reason for an individual symptom. Do not wait for symptoms to become severe before arranging professional assessment.
When should you see a healthcare professional?
Make an appointment with a healthcare professional if you experience vaginal bleeding after menopause, bleeding between periods, pelvic pain or any symptom that worries you.
These symptoms do not prove that cancer is present. They do mean that symptoms need professional assessment to find the cause.
What causes endometrial cancer?
The cause of endometrial cancer is not known. The disease begins when cells in the endometrium develop changes in their DNA. [4]
DNA contains instructions that guide a cell’s behavior. Changes can tell cells to multiply quickly and continue living when healthy cells would normally die. The extra cells may form a tumor, invade nearby tissue and eventually spread to other parts of the body. [4]
What are the risk factors for endometrial cancer?
The following factors are associated with a higher risk of endometrial cancer:
Risk factor | How it is described |
Hormone imbalance | More estrogen without enough progesterone can change the endometrium. Conditions linked with this pattern include obesity, diabetes and irregular ovulation associated with polycystic ovary syndrome. |
Estrogen-only therapy after menopause | Estrogen without progestin after menopause can increase risk when the uterus is present. |
More years of menstruation | Starting periods before age 12 or entering menopause later increases lifetime exposure of the endometrium to estrogen. |
Never having been pregnant | The risk is higher compared with having had at least one pregnancy. |
Older age | Endometrial cancer occurs most often after menopause. |
Obesity | Extra body fat can alter the body’s hormone balance. |
Tamoxifen | Hormone therapy for breast cancer can increase risk, although the benefits of tamoxifen outweigh the small risk for most people. |
Lynch syndrome | This inherited syndrome increases the risk of colon cancer and other cancers, including endometrial cancer. |
A risk factor does not diagnose endometrial cancer. Risk varies between people, and personal risk questions should be discussed with a healthcare team.
Can the risk of endometrial cancer be reduced?
Discuss postmenopausal hormone therapy. If you are considering hormone therapy for menopause symptoms, ask about the benefits and risks. Estrogen alone may increase endometrial cancer risk when the uterus is present, while combined estrogen and progestin can reduce that risk. Hormone therapy has other risks, so the decision should be individualized.
Ask about oral contraceptives. Using oral contraceptives for at least one year may reduce endometrial cancer risk, and the reduction may last for several years after stopping. Oral contraceptives also have side effects, so discuss potential benefits and risks with a healthcare team.
Maintain a healthy weight. Obesity is linked with increased risk. If weight loss is appropriate for you, seek practical guidance about safe activity and nutrition. [4]
These points are general information, not personal recommendations. Do not start, stop or change hormone therapy or contraception without discussing it with a qualified healthcare professional.
How is endometrial cancer diagnosed?
Diagnosis may require several tests. The choice depends on symptoms, examination findings and the information the healthcare team needs.
Pelvic exam
During a pelvic exam, a healthcare professional examines the reproductive organs. A speculum may be used to view the vaginal canal, while the clinician checks the uterus and ovaries. [5]
A pelvic exam can be part of a routine checkup or may be recommended when symptoms raise concern. It does not replace other tests when more information is needed.
Imaging tests
Imaging creates pictures of the inside of the body. A transvaginal ultrasound uses a wandlike device to create images of the pelvic organs and can show the thickness and texture of the endometrium. [5]
Other imaging tests, including MRI and CT scans, may also be suggested. These tests can help the healthcare team assess the location and size of a possible cancer and consider other causes of symptoms. [5]
Hysteroscopy
During a hysteroscopy, a thin, lighted instrument is passed through the vagina and cervix into the uterus. The instrument allows the healthcare professional to look at the inside of the uterus and the endometrium. [5]
Endometrial biopsy
An endometrial biopsy removes a sample of tissue from the uterine lining. The sample is sent to a laboratory to check for cancer cells. Additional tests may provide more information about the cells and help the healthcare team create a treatment plan. [5]
Dilation and curettage
If a biopsy does not provide enough tissue or the results are unclear, a procedure called dilation and curettage, often shortened to D&C, may be needed. Tissue is removed from the uterine lining and examined under a microscope. [5]
How is endometrial cancer staged?
After diagnosis, the healthcare team works to determine how far the cancer has grown or spread. This is called staging. [5]
Tests used for staging may include a chest X-ray, CT scan, blood tests and PET scan. The full stage may not be known until after surgery. Stages range from 1 to 4:
Stage | General meaning |
Stage 1 | The cancer has not grown beyond the uterus. |
Stages 2–3 | The cancer has grown farther into nearby tissues or areas; the exact meaning depends on clinical findings. |
Stage 4 | The cancer has involved nearby organs, such as the bladder, or has spread to distant areas. |
Staging helps guide treatment planning. It cannot be determined from symptoms alone.
How is endometrial cancer treated?
Treatment usually begins with surgery to remove the cancer. Other options may include radiation therapy and medicines that kill or slow cancer cells. The treatment plan depends on the cancer’s characteristics, including its stage, as well as general health and personal preferences. [5]
Treatment | General role |
Surgery | Usually includes hysterectomy, often with removal of the fallopian tubes and ovaries; lymph nodes may be checked. |
Radiation therapy | May be given before surgery in certain situations or used when surgery is not suitable. It may be external or internal (brachytherapy). |
Chemotherapy | May be used before or after surgery, for advanced disease or for cancer that has returned. |
Hormone therapy | May be an option for advanced cancer cells that rely on hormones to grow. |
Targeted therapy | Usually combined with chemotherapy for advanced endometrial cancer. |
Immunotherapy | May be considered for advanced disease when other treatments have not helped. |
Palliative care | Helps relieve pain and other symptoms and improve quality of life during serious illness. |
Surgery
Surgery usually involves a hysterectomy, which removes the uterus. It also commonly includes removal of the fallopian tubes and ovaries, called a salpingo-oophorectomy. [5]
A hysterectomy makes future pregnancy impossible. Removing the ovaries causes menopause if menopause has not already occurred. During surgery, the surgeon may inspect nearby areas and remove lymph nodes for testing to help determine the stage. [5]
Radiation therapy
Radiation therapy uses powerful energy to kill cancer cells. It may be recommended before surgery in certain situations to shrink a tumor and make it easier to remove.
Radiation may also be used alone when a person is not healthy enough for surgery. External-beam radiation directs energy from a machine outside the body. Internal radiation, called brachytherapy, places a radiation-filled device inside the vagina for a short period. [5]
Chemotherapy
Chemotherapy uses strong medicines to kill cancer cells. Some people receive one medicine, while others receive multiple medicines together. Medicines may be given through a vein or taken as pills. [5]
Chemotherapy may be used after surgery to lower the risk that cancer will come back, before surgery to shrink cancer, or for advanced or recurrent disease. [5]
Hormone therapy
Hormone therapy lowers hormone levels in the body. It may be an option when advanced endometrial cancer cells rely on hormones to help them grow. [5]
Targeted therapy and immunotherapy
Targeted therapy uses medicines that attack specific chemicals in cancer cells. It is usually combined with chemotherapy for advanced endometrial cancer. [5]
Immunotherapy helps the immune system find and kill cancer cells. It may be considered when endometrial cancer is advanced and other treatments have not helped. [5]
What is palliative care?
Palliative care is specialized healthcare that helps relieve pain and other symptoms of a serious illness. It is delivered by a team that may include doctors, nurses and other trained professionals. [5]
Palliative care can be provided at the same time as cancer treatment, including surgery, chemotherapy or radiation therapy. Its goal is to improve quality of life for the person and family. [5]
Coping and support
A cancer diagnosis can bring fear, questions and uncertainty. Ways to find support include:
Learn enough to participate in decisions. Ask about the cancer’s stage, treatment options and possible side effects.
Maintain a support system. Talk with close friends and family members about how you are feeling.
Use support groups. Ask the healthcare team about support groups in your area or online.
Stay involved in usual activities when possible. Continue familiar activities when you feel able.
You do not need to make every decision alone. A trusted person may help you remember questions and information during appointments.
How can you prepare for an appointment?
If you have symptoms that worry you, make an appointment with a gynecologist or another healthcare professional. If endometrial cancer is diagnosed, referral to a gynecologic oncologist is likely. Before the appointment, write down:
Your symptoms and when they started.
All medicines, vitamins and supplements.
Any past hormone therapy, including birth control pills, tamoxifen or other treatments.
Your personal and family history of cancer.
The questions that matter most to you.
Useful questions may include:
What tests are needed to diagnose the cause of my symptoms?
Will I need additional tests for staging?
What does the biopsy show?
Has the cancer spread, and what stage is it?
What treatments are available?
What side effects could each treatment cause?
How could treatment affect sexuality, fertility or daily life?
Should I see a gynecologic oncologist?
What support services are available?
Frequently asked questions
What is endometrial cancer?
Endometrial cancer is cancer that begins in the lining of the uterus, called the endometrium. It is sometimes called uterine cancer, although other types of cancer can also form in the uterus.
What is the first symptom of endometrial cancer?
Irregular vaginal bleeding is often the first symptom. This can include bleeding after menopause or bleeding between periods.
Is bleeding after menopause a symptom of endometrial cancer?
Bleeding after menopause is a possible symptom and should be discussed with a healthcare professional. It does not prove that cancer is present, but it should not be ignored.
What causes endometrial cancer?
The cause is not known. The disease begins when cells in the uterine lining develop DNA changes that can make them multiply quickly and survive longer than healthy cells.
What are the risk factors for endometrial cancer?
Risk factors include hormone imbalance, older age, obesity, never having been pregnant, more years of menstruation, tamoxifen use and Lynch syndrome. A risk factor does not diagnose cancer.
How is endometrial cancer diagnosed?
Diagnosis may include a pelvic exam, transvaginal ultrasound, MRI or CT, hysteroscopy, endometrial biopsy and sometimes dilation and curettage. The appropriate tests depend on the clinical situation.
What are the stages of endometrial cancer?
Stages range from 1 to 4. Stage 1 means the cancer has not grown beyond the uterus, while stage 4 means it has involved nearby organs or spread to distant areas.
How is endometrial cancer treated?
Treatment often starts with surgery. Depending on the cancer’s characteristics, stage, general health and preferences, care may also include radiation, chemotherapy, hormone therapy, targeted therapy, immunotherapy or palliative care.
What is a gynecologic oncologist?
A gynecologic oncologist is a doctor who specializes in treating cancers involving the reproductive system. People diagnosed with endometrial cancer are likely to be referred to one.
Can endometrial cancer be cured?
When endometrial cancer is found early, surgically removing the uterus often cures it. An individual outcome depends on clinical findings, stage, treatment and other factors, so it cannot be predicted from a general article.
Conclusion: what to remember about endometrial cancer
Endometrial cancer begins in the uterine lining, and unusual vaginal bleeding is often the first warning sign. Bleeding after menopause, bleeding between periods or pelvic pain deserves professional attention, even though these symptoms can have causes other than cancer.
Diagnosis requires clinical testing, and staging may not be complete until after surgery. Treatment depends on the cancer’s characteristics, general health and preferences, with options that may include surgery, radiation, chemotherapy, hormone therapy, targeted therapy, immunotherapy and palliative care. If you have symptoms that worry you, make an appointment with a qualified healthcare professional rather than relying on an online article.
Related Reading
Endometrial Biopsy: Why It's Done, What to Expect, Pain, Recovery and Results explains the office test used to sample the uterine lining and diagnose this condition.
Sonohysterogram (Saline Infusion Sonography): Why It's Done, What to Expect, Pain and Results explains how saline and ultrasound show the inside of the uterus, what the test feels like and what it can find.
References
Clarke MA, Long BJ, Del Mar Morillo A, et al. Association of endometrial cancer risk with postmenopausal bleeding in women: a systematic review and meta-analysis. JAMA Intern Med. 2018;178(9):1210-1222. PMID 30083701. https://doi.org/10.1001/jamainternmed.2018.2820
Aune D, Navarro Rosenblatt DA, Chan DS, et al. Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies. Ann Oncol. 2015;26(8):1635-1648. PMID 25791635. https://doi.org/10.1093/annonc/mdv142
Secord AA, Hasselblad V, Von Gruenigen VE, et al. Body mass index and mortality in endometrial cancer: a systematic review and meta-analysis. Gynecol Oncol. 2016;140(1):184-190. PMID 26524722. https://doi.org/10.1016/j.ygyno.2015.10.020
Mayo Clinic Staff. Endometrial cancer: Symptoms and causes. Mayo Clinic. July 29, 2025. https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461
Mayo Clinic Staff. Endometrial cancer: Diagnosis and treatment. Mayo Clinic. July 29, 2025. https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/diagnosis-treatment/drc-20352466
Disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition.
It does not diagnose cancer, determine a person’s risk or recommend an individual treatment plan. Unusual bleeding, pelvic pain or other worrying symptoms need assessment by a qualified healthcare professional.
Comments