Cancer symptoms and silent warning signs every postmenopausal woman must know

Menopause is a natural part of aging, defined by 12 months without a menstrual period,ii usually occurring in the late 40s or early 50s. It marks the end of reproductive years, but it should never mark the end of gynaecological care. Menopause is accompanied by various biological and physical changes that can affect long-term health. As women age, the risk of developing gynaecological cancers increases. With increasing life expectancy and decreasing age at menopause, women spend nearly one-third of their lifespan in the postmenopausal phase, making vigilance more important than ever.
Here are five things every woman should know about gynaecological cancer risk in the postmenopausal years:
(Dr. Jeyhan B. Dhabhar, Medical oncologist and Hemato-oncologist, Jaslok Hospital & Research Centre, Mumbai)

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Bleeding from your vagina after menopause isn’t normal!
Any bleeding that happens a year or more after your last period is unusual and should never be ignored. While dryness or thinning of the vaginal lining can sometimes cause spotting, bleeding can also signal cancers of the uterus, cervix, or ovaries. Research shows that 90% of women with endometrial cancer experience vaginal bleeding before diagnosis. After menopause, if a woman experiences light bleeding or spotting, pink or brown discharge and heavy bleeding, even if it only happens once or twice, she should get it checked immediately. This early reporting can allow for earlier diagnosis of the underlying condition when there are generally more treatment options available. Early diagnosis can give the best chance for successful treatment.

Symptoms of menopause can often be very similar to the symptoms of various gynaecological cancers like endometrial, ovarian and cervical cancer. Because of this, women may dismiss warning signs as normal and not seek any medical advice. Ovarian cancer, for example, often shows only subtle symptoms, like pelvic discomfort, bloating, feeling full quickly, fatigue, frequent urination, or loss of appetite in its early stage. Some of the symptoms of gynecologic cancers, including uterine, ovarian and cervical cancer, can be very similar to the symptoms of menopause. This similarity can delay diagnosis and treatment at a time when early detection matters most. That is why it is important for women to pay close attention to their bodies and discuss any unusual or persistent changes with a doctor.

Conditions like obesity add to the risk of gynecological cancers. Age increases the risk of obesity which increases the risk of gynaecological cancers. As women enter their menopausal transition phase, the body begins to use energy differently. The distribution of fat in the body changes, and women lose muscle and gain weight more easily, further increasing the risk of obesity. Endometrial cancer has the strongest association with obesity. This makes it important for women to take care of their weight.

A family history of gynaecological cancers means that your risk is even higher. For ovarian cancer in particular, key risk factors include advancing age, genetics, a family history of the disease, use of hormone replacement therapy, not having children, and a high-fat diet. This makes it essential for postmenopausal women with family history of cancer to continue routine check-ups and discuss risks with their doctor.

The way we treat gynaecological cancers is transitioning now with new precision-led therapies entering the landscape.xxv With the help of biomarker testing, a doctor can tailor the treatment more precisely. These precision-led therapies show better outcomes at different timepoints in a patient’s journey.
Menopause puts a full stop on menstruation, but it shouldn’t mark the end of gynaecological care. Postmenopausal women should remain vigilant of their health and get timely check-ups. They should talk to their healthcare provider about how often appointments should be scheduled based on their health history and risk.