Menopause and Cancer Risk

Approved by the Cancer.Net Editorial Board, 09/2019

Menopause occurs when a woman’s ovaries stop releasing eggs.

During natural menopause, the body’s estrogen and progesterone hormone production decreases. This causes irregular menstrual periods that eventually stop. Typically, menopause starts around age 50. However, it may often start earlier or later.

For women with cancer, menopause may begin earlier. For example, some treatments cause the ovaries to stop working. This is called premature menopause. Learn more about long-term side effects of cancer treatment.

Symptoms of menopause include:

  • Hot flashes

  • Night sweats

  • Fatigue

  • Vaginal dryness

  • Painful sexual intercourse

  • Decreased sex drive

  • Osteoporosis, which makes bones weak and fragile

  • Bladder control difficulties

  • Recurrent bladder infections

  • Mood swings and irritability

  • Depression

  • Anxiety

  • Sleeping problems, also called insomnia

  • Irregular or heavy menstruation

  • Weight gain

  • Hair loss

  • Food cravings

  • Fuzzy thinking or forgetfulness

Learn how to manage menopausal symptoms.

Menopause and cancer risk

Two main factors are linked with increased cancer risk after menopause:

  • Increased exposure to hormones, such as estrogen

  • Increased number of ovulations

Ovulation occurs when the ovary releases eggs. Women who menstruate for many years have many ovulations, which increases the risk of uterine, breast, and ovarian cancers. This includes women who:

  • Begin menstruating before age 12

  • Start menopause after age 55

Oral contraceptives

Oral contraceptives are commonly called birth control pills. Research shows that they can lower ovarian cancer risk. This is because these medications often stop ovulation temporarily. Talk with your doctor about your risk of cancer. And ask about the risks and benefits of oral contraceptives.

Combined hormone therapy and cancer risk

Combined hormone therapy may help relieve menopausal symptoms such as hot flashes and osteoporosis. Combined hormone therapy is also called postmenopausal hormone therapy or hormone replacement therapy (HRT).

HRT is a combination of estrogen and progestin. Progestin is a form of progesterone made in a laboratory.

The National Institutes of Health conducts the Women’s Health Initiative study. This study has found that HRT increases the risk of certain conditions.

Women’s Health Initiative study

The study found that women taking HRT have a higher risk of these conditions:

  • Breast cancer

  • Heart attack

  • Stroke

  • Blood clots

However, the study showed that these women had a lower risk of colorectal cancer and bone fractures.

Meanwhile, other research suggests that HRT may increase the risk of dying from non-small cell lung cancer.

HRT recommendations

Because of the risks, doctors typically do not recommend HRT, particularly for women who:

  • Have a history of breast cancer

  • Have a higher risk of breast cancer

Sometimes, women receive HRT at a low dose. This is done for a short time for severe menopausal symptoms.

Other times, doctors consider HRT with estrogen alone. This option is only for women who have had a hysterectomy. A hysterectomy is the surgical removal of the uterus. Estrogen not balanced by progesterone can lead to uterine lining growth. That growth increases the risk of uterine cancer.

The effects of HRT on women are controversial. Additionally, the risks and benefits are different for each woman. Research in this area is ongoing.

If you are considering HRT, talk with your doctor. Share your symptoms and medical history. And ask about options for relieving your symptoms. Then, weigh the associated risks and benefits.