People who have been diagnosed with polycystic ovary syndrome (also known as polycystic ovarian syndrome or PCOS) are up to five times more likely to be diagnosed with endometrial cancer. Between 30 percent and 44 percent of females with PCOS will eventually be diagnosed with endometrial cancer, according to a large-scale analysis in Oncology Letters. These individuals are at a significantly higher risk for endometrial cancer than people who don’t live with PCOS.

Between 30 percent and 44 percent of females with PCOS will eventually be diagnosed with endometrial cancer.

Whether you’ve been diagnosed with endometrial cancer or not, if you’ve been diagnosed with PCOS, it’s important to understand the connection between the two conditions so that you and your doctor can work together to do what’s best for your body.

What Is PCOS?

PCOS occurs when your ovaries create too many hormones called androgens. This causes an overall hormonal imbalance, which can make your menstrual cycle unpredictable. Many people diagnosed with PCOS have cysts on their ovaries, which happens when the body doesn’t ovulate (release eggs) the way it normally does. However, you don’t have to have ovarian cysts to be diagnosed with PCOS, and having ovarian cysts doesn’t mean you have PCOS.

PCOS is relatively common. According to Cleveland Clinic, up to 15 percent of women and people who were assigned female at birth are diagnosed with the condition. Most people have some or all of the following symptoms of PCOS, though it is possible to have the condition without any symptoms at all. The most common symptoms are:

• Irregular periods
• Heavy periods
• Acne
• Darkening skin
• Skin tags
• Extra hair growth (usually on your face, chest, arms, or abdomen)
• Thinning hair
• Obesity (having a body mass index, or BMI, over 30)
• Infertility

No one knows exactly what causes PCOS. It does have a genetic component, though family history is not enough to explain all cases. Having obesity, being insulin resistant, having inflammation in your body, and having high levels of androgens may all have a role in causing the syndrome.

Why Is PCOS Connected to Endometrial Cancer?

The exact connection between PCOS and endometrial cancer isn’t known at this time. It is, however, one of several conditions that are connected to this kind of cancer.

Researchers have found some characteristics of PCOS that may be linked to endometrial cancer. It’s important to note that some people with PCOS will never develop endometrial cancer.

If you’re worried and want to understand your risk factors, talk to your health care provider. They can help you stay calm even when you’re concerned, and they can look for symptoms of endometrial cancer. If you do have endometrial cancer, they can connect you to an oncology (cancer) team so you’ll get the treatment you need.

Too Many Androgens

Having too many androgens in your body, among other factors, is connected to an increased risk of endometrial cancer. This is one of the main signs of PCOS. Researchers suspect that these hormones cause cells in the endometrium (tissue that lines the uterus) to grow faster than usual. However, it may be more complex than that. They may only cause certain cells in the endometrium to grow, or they may only cause extra growth at certain times in the hormonal cycle. Cells growing too fast can lead to cancer.

Too Much Insulin

Having high levels of insulin in the bloodstream is also connected to endometrial cancer in people living with PCOS. Insulin may cause cells in the endometrium to grow too fast. It may also cause the body to produce even more androgens. Finally, insulin may make it easier for cells to bind with estrogen, which may cause cells to grow and divide even faster in the endometrium.

Ongoing, Long-Term Inflammation

Chronic inflammation may also be a connection between PCOS and a higher risk of endometrial cancer. Inflammation is one of several issues in the body that make it easier for tumors to grow. When your body is inflamed for a long time, you can end up with damage to your DNA. This can change the way those cells grow and divide, which can lead to cancer over time.

Too Many Fats in the Bloodstream

Having high levels of fats (like cholesterols and triglycerides) in your bloodstream is tied to a higher risk of endometrial cancer. The fat levels in your bloodstream are associated with PCOS, though not everyone living with PCOS will have this complication. If you do, however, it can promote the growth of endometrial tumors. Researchers are currently trying to understand exactly what these high levels of fats mean in the body and how they lead to endometrial cancer.

Too Much Exposure to Estrogen

Estrogen may also be connected to endometrial cancer risk. When you don’t experience ovulation regularly, the endometrium may end up exposed to estrogen for a long period of time. This is because nothing happens to change your hormone levels and move your menstrual cycle along.

Once again, researchers don’t know exactly why this might lead to endometrial cancer, but it definitely seems to raise the risk. In general, estrogen causes cells in the endometrium to grow. It makes sense that, if this process never stops, endometrial cancer might develop.

Obesity

Somewhere between 40 percent and 80 percent of people with PCOS also live with obesity and struggle to maintain a healthy weight. Obesity may also raise your risk of endometrial cancer. In fact, up to 50 percent of endometrial cancer cases may be associated with obesity. Obesity is also tied to issues with blood sugar and inflammation, as well as to higher levels of fats in your blood. This may mean it is a factor that ties PCOS and endometrial cancer together, though more research is needed to understand that connection might work.

Between 40 percent and 80 percent of people with PCOS have obesity, which may raise their risk of endometrial cancer.

A Combination of Factors

Several of the studies mentioned above seem to suggest that a combination of these factors is what connects PCOS to a higher risk of endometrial cancer. Many of these causes are also connected to metabolic syndrome, and about 43 percent of people with PCOS also have this condition. Thus, if you have been diagnosed with metabolic syndrome alongside PCOS, you may want to talk to your gynecology team about endometrial cancer, too.

How To Lower Your Risk for Endometrial Cancer if You’ve Been Diagnosed With PCOS

There are a few things you can do to lower your risk of endometrial cancer if you live with PCOS. Your doctor can help you figure out which of these ideas may be right for you:

• Getting regular Pap smears and pelvic exams — These can help you find cancer and precancer early, so it’s important to follow up with your doctor every year.
• Limit how much fat you eat — The way your body uses fat affects your estrogen levels, so eating less of it may mean less estrogen, and less estrogen may lower your risk of endometrial cancer.
• Talk to your doctor about the best way for you to treat PCOS — If your hormone levels normalize, it may lower your risk of developing endometrial cancer.
• Get your body moving — You may be more likely to develop endometrial cancer if you aren’t active, so regular physical activity may lower your risk.
• Eat a mainly plant-based diet — Getting plenty of fruits, vegetables, legumes, and whole grains and may lower your endometrial cancer risk.
• Try the Mediterranean diet — If plant-based eating is too hard for you, the Mediterranean diet includes the foods above as well as fish. It can lower your endometrial cancer risk.

Talk With Others Who Understand

On MyEndometrialCancerTeam, the site for people with endometrial cancer and their loved ones, people come together to gain a new understanding of endometrial cancer and share their stories with others who understand life with endometrial cancer.

Have you been diagnosed with PCOS before or alongside endometrial cancer? Share your experience in the comments below. Share your experience in the comments below or post to your Activities feed.