Cancer Risks and Menopause: What to Know

Every woman who lives long enough will reach menopause, the time in life when menstrual cycles have stopped. You’ll receive a menopause diagnosis once you have gone a full year without having a menstrual period.

”Menopause itself does not cause cancer. However, as women get older, their risk for many types of cancers goes up,” says JoAnn Pinkerton, MD, a professor of obstetrics and gynecology at the University of Virginia Health System in Charlottesville and an executive director emerita of the North American Menopause Society. “This means women after menopause have a higher chance of developing cancer, mainly because of their age.”

“Women who have a late menopause, after age 55, have a higher risk of breast and uterine cancer. This is because they are exposed to estrogen for a longer time, which can fuel these cancers,” states Dr. Pinkerton. Their risk of ovarian cancer is also a bit higher, possibly because they have had more ovulation cycles.”

The association between hormone replacement therapy and cancer is complex and not completely understood.

Researchers have reported varying results around HRT and cancer:

• Women who took estrogen plus progestin had a slightly increased risk of breast cancer. According to one study, for every 10,000 women who took estrogen plus progestin for one year, there were 14 extra cases of breast cancer.

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• Some research has shown that women without a uterus who took estrogen-only therapy had a lower risk of breast cancer than those who took combined HRT.

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  However, other studies have found that estrogen alone may raise the risk of breast cancer if it’s used for a long time.

Research on the link between hormone therapy and other cancers isn’t straightforward either.

“Menopausal hormone therapy (MHT) is linked to a small increase in ovarian cancer risk, especially if used for more than 5 to 10 years. The overall risk is still low,” advises Pinkerton. “The risk may be higher for women who use estrogen alone after a hysterectomy compared to those who use both estrogen and progestin. The risk usually goes down after stopping hormone therapy.”

A range of factors can impact a woman’s choice to pursue MHT, and she should discuss them with her clinician. “When deciding about hormone therapy, it is important to weigh the benefits, like relief from symptoms, better quality of life, and prevention of bone loss, against the possible risks,” says Pinkerton. “This can help each woman make the best choice for her situation.”

The primary purpose of HRT is relief from menopausal symptoms.

Talk to your doctor to weigh the potential benefits and risks and see if HRT is right for you. For many women, the newer low-dose options can offer relief that offsets the dangers.

• Average-risk women should undergo a screening mammogram starting at 40 years of age and no later than age 50.
• Average-risk women should have a screening mammogram every one or two years.
• Average-risk women should continue mammography screening until at least age 75.

“Pelvic exams and routine screening for ovarian cancer have limited ability to pick up ovarian cancer,” recommends Pinkerton. “However, if a woman has new persistent symptoms of bloating, pelvic or abdominal pain, abdominal distention, or a persistent change in feeling full after eating, or has a change in bladder or bowel symptoms, we recommend additional evaluation, including a pelvic ultrasound and a blood test for cancer antigen 125.”

Pinkerton advises that early detection can greatly improve survival rates, and to contact your doctor if you have new or ongoing symptoms that last more than a few weeks.

• Avoid smoking. About 30 percent of all cancer deaths occur due to long-term tobacco use.
• Exercise. Physical activity may help to lower the risk of several cancers, including those of the breast and endometrium. Adults should get at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity each week.
• Maintain a healthy weight. Being overweight is a risk factor for many different types of cancer.
• Limit alcohol. Drinking too much alcohol can increase your risk of breast cancer. Women should have no more than one drink a day.
• Eat healthy. A healthy diet has links to a lower risk of certain cancers. Try to eat at least two and a half cups of fruits and veggies a day.
• Practice safe sex. Use condoms when you have sexual intercourse, and limit the number of sexual partners you have. The more sexual partners you have in your lifetime, the more likely you are to contract a sexually transmitted infection, such as HPV.

The bottom line? Practice healthy habits in midlife to reduce your risk of disease.

“Menopause is a perfect time for women to assess their risk for cancer, get important screening tests like mammograms, colonoscopies, and Pap smears, and improve their health by exercising, eating healthy, and managing their weight to decrease their risk of cancer,” Pinkerton concludes.

• Menopause itself does not cause cancer, but as women age, their risk of developing certain cancers, like ovarian and endometrial cancer, may increase. It is crucial to consult a healthcare provider regularly to discuss screening options and other concerns.
• While hormone replacement therapy can be effective for managing menopausal symptoms, it is associated with complex cancer risks. If you are considering HRT, discuss the potential benefits and risks with your doctor to determine if it is the right option for you.
• Adopting healthy lifestyle habits, such as quitting smoking, maintaining a healthy weight, exercising regularly, and eating a balanced diet rich in fruits and vegetables, may help reduce the risk of developing cancer after menopause.
• Regular cancer screenings, including mammograms, HPV tests, and Pap tests, are vital for early detection. If you experience persistent abdominal pain or other unusual symptoms, seek evaluation from a healthcare professional for conditions like ovarian cancer.