Understanding PCOS and its impact on menstrual health and cancer risk

Many people who menstruate may experience irregular periods, and this is not an uncommon occurrence. Approximately one in four individuals who menstruate may encounter menstrual irregularities. These irregularities can manifest in various ways, such as shorter or longer cycles or extended gaps between periods (more than three months apart). Several factors can contribute to these changes, including pregnancy, hormonal birth control pills, stress, illness, endometriosis, sexually-transmitted infections, and hormone disorders like polycystic ovary syndrome (PCOS). In his latest online article, Mr Mahantesh Karoshi gives us his insights.

PCOS and menstrual irregularities

PCOS is a common hormonal imbalance condition with lasting consequences. Those diagnosed with PCOS often experience missed or infrequent periods, contributing to the complexity of their menstrual health. In addition to menstrual irregularities, individuals with PCOS face an increased risk of metabolic and fertility problems. This condition is particularly significant as it is linked to endometrial hyperplasia, a condition that involves the thickening of the uterine lining.

Understanding the link between PCOS and endometrial cancer

Endometrial hyperplasia is a critical concern associated with PCOS, as it can potentially progress to endometrial cancer if left untreated. The relationship between PCOS, menstrual irregularities, body size (BMI), and the risk of endometrial cancer is varied. Elevated oestrogen levels, often found in those with higher BMIs, can lead to the excessive thickening of the uterine lining. People with PCOS are more likely to have both higher oestrogen levels and BMIs, heightening their susceptibility to endometrial hyperplasia and endometrial cancer.

The role of hormonal imbalance

The imbalance between oestrogen and progesterone can contribute to endometrial hyperplasia. Elevated oestrogen levels, particularly in individuals with higher BMIs due to excess fat cells producing oestrogen, can result in the excessive thickening of the uterine lining. Prolonged exposure to oestrogen, without regular menstruation to shed the uterine lining, increases the risk of endometrial hyperplasia and subsequently, endometrial cancer.

Associations and observations

While observational data highlights a connection between PCOS and endometrial hyperplasia or cancer, it does not establish a causal relationship. However, recognising this association is crucial, as it can prompt individuals with PCOS to seek medical advice promptly if they experience irregular bleeding. Timely intervention and management can mitigate the risks associated with endometrial hyperplasia and potentially prevent the progression to endometrial cancer.

Endometrial cancer

Endometrial cancer, also known as lining of the womb cancer, has become the most prevalent gynaecological cancer, surpassing even ovarian and cervical cancers. Its incidence has increased alongside rising obesity rates. Previous studies have shown that irregular and prolonged menstrual cycles over a person's reproductive lifespan are associated with a higher risk of cancer, particularly obesity-related cancers.

Mr Mahantesh Karoshi is an esteemed consultant gynaecologist. You can schedule an appointment with Mr Karoshi on his Top Doctors profile.