Why do PCOS/PMOS and obesity raise endometrial cancer risk?

Question

Hi doctor,

I am a 45-year-old woman who is overweight and has PCOS/PMOS. I read that obesity and hormone imbalance can increase the risk of endometrial cancer. However, I have a few questions.

Can you explain in simple language how hormones like estrogen affect the uterus lining?
Are there lifestyle changes that truly lower risk?
Should I have regular screenings even if I do not have symptoms?

Kindly help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Yes, PCOS (polycystic ovary syndrome)/polyendocrine metabolic ovarian syndrome (PMOS) and obesity can increase the risk of cancer of the uterine lining (endometrial cancer), but it does not mean that everyone with these conditions will develop cancer.

In obesity, the extra body fat can produce more estrogen, a hormone that stimulates the lining of the uterus. In PCOS, ovulation often does not occur regularly, so the body does not produce enough progesterone, the hormone that normally balances the effect of estrogen. Because of this imbalance, the uterine lining may keep growing thicker without shedding regularly during periods. Over a long time, this persistent thickening can sometimes lead to abnormal changes in the lining, which may increase the risk of endometrial cancer.

There is no regular screening program for endometrial cancer, but if a person has symptoms such as irregular, heavy, or prolonged bleeding or a history of amenorrhoea, as in PCOS/PMOS.

A transvaginal ultrasound can help check the thickness of the uterine lining, and if needed, a small sample of the lining (endometrial biopsy) may be taken to examine the cells.

The risk can be reduced by maintaining a healthy weight, regular exercise, and proper treatment of PCOS/PMOS, which helps keep hormones balanced and periods more regular.

I hope this helps.

Thank you.