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Changes in menstrual bleeding are common throughout a woman’s life and are often linked to hormonal fluctuations, stress, perimenopause, or other benign gynaecological conditions. However, persistent or unexpected bleeding, particularly after menopause, should never be ignored. It is one of the earliest and most common warning signs of endometrial cancer, the most common cancer affecting the lining of the uterus.
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Because abnormal bleeding often appears early in the disease, many women are diagnosed when treatment is most effective. Dr Amita Naithani, Senior Consultant, Gynecology & Robotic Surgery, Apollo Athenaa Women’s Cancer Centre, says understanding the warning signs, risk factors, diagnosis, and treatment options can help women seek timely medical care and improve outcomes.
Dr Amita Naithani: Endometrial cancer develops in the endometrium, the inner lining of the uterus. It is the most common gynaecological cancer in many countries. It most often affects women after menopause, although younger women can also develop the disease.
Dr Amita Naithani: Abnormal uterine bleeding may include:
Dr Amita Naithani: No. Many women experience abnormal bleeding due to non-cancerous conditions such as fibroids, endometrial polyps, hormonal imbalances, infections, or medication-related effects. However, persistent or recurrent bleeding should always be evaluated by a healthcare professional to identify the underlying cause.
Dr Amita Naithani: Menopause marks the permanent end of menstrual cycles. Therefore, any vaginal bleeding after menopause is considered abnormal. While many cases have benign causes, postmenopausal bleeding remains one of the most important warning signs of endometrial cancer and requires prompt medical evaluation.
Dr Amita Naithani:
Several factors can increase the risk of endometrial cancer, including:
Women with polycystic ovary syndrome (PCOS) may also have an increased risk because chronic irregular ovulation can result in prolonged exposure of the uterine lining to estrogen.
Dr Amita Naithani: Diagnosis may involve a pelvic examination, transvaginal ultrasound, endometrial biopsy, or hysteroscopy. Among these, an endometrial biopsy is often the most definitive test, as it helps determine whether abnormal bleeding is caused by cancer or another condition.
Dr Amita Naithani: There is no guaranteed way to prevent endometrial cancer. However, maintaining a healthy weight, managing diabetes and other metabolic conditions, staying physically active, and seeking medical advice for persistent abnormal bleeding may help reduce the risk or enable earlier diagnosis. Women with known risk factors should also attend regular gynaecological check-ups.
Dr Amita Naithani: Yes. When diagnosed early, endometrial cancer is highly treatable and is associated with excellent outcomes. Surgery remains the mainstay of treatment for most women with early-stage disease.
For many patients, minimally invasive robotic-assisted surgery is now widely used because it offers greater precision, smaller incisions, less blood loss, reduced postoperative pain, shorter hospital stays, and faster recovery compared with traditional open surgery. Depending on the stage and individual risk profile, additional treatments such as radiation therapy, chemotherapy, immunotherapy, or hormonal therapy may also be recommended.
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