Endometrial Cancer: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Endometrial Cancer?
A gynecologic oncologist treats endometrial cancer. This is a doctor trained to treat cancers of the female reproductive organs. Your care team may include other cancer doctors too. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is endometrial cancer?
Endometrial cancer is cancer that starts in the endometrium, the lining of the uterus (womb). It is the most common type of uterine cancer.
Symptoms
Symptoms of endometrial cancer include:
- Abnormal bleeding from the vagina, including bleeding between periods or spotting and bleeding after menopause.
- Long, heavy, or frequent episodes of vaginal bleeding after age 40.
- Lower belly pain or pelvic cramping.
Blood loss before diagnosis can lead to anemia, which means too few healthy red blood cells.
Causes and who gets it
The exact cause of endometrial cancer is not known. A higher level of the hormone estrogen may play a role. Estrogen makes the lining of the uterus build up. This can lead to overgrowth and then cancer.
Most cases happen after menopause. The average age at diagnosis is about 60. These factors raise the risk:
- Estrogen replacement therapy without progesterone.
- A history of endometrial polyps.
- Infrequent periods.
- Never being pregnant.
- Obesity.
- Diabetes.
- Polycystic ovary syndrome (PCOS).
- Starting periods before age 12.
- Starting menopause after age 50.
- Tamoxifen, a medicine used to treat breast cancer.
Women with colon or breast cancer, gallbladder disease, or high blood pressure also seem to have a higher risk. A normal weight lowers the risk. So does using birth control pills for over a year.
How doctors diagnose it
In the early stages, a pelvic exam is often normal. A Pap smear may raise suspicion for endometrial cancer, but it does not diagnose it. Your provider may order other tests:
- Endometrial biopsy: a thin tube takes a bit of tissue from the lining of the uterus. A lab checks the cells for cancer.
- Hysteroscopy: a thin, telescope-like tool goes through the vagina and cervix. The provider can then see inside the uterus.
- Ultrasound: sound waves make a picture of the pelvic organs. It shows if the lining looks thick or abnormal.
- Sonohysterography: fluid is put in the uterus. Then ultrasound pictures are taken.
- MRI: strong magnets make pictures of the organs.
If cancer is found, imaging tests may show whether it has spread. Doctors also give the cancer a grade of 1, 2, or 3. Grade 1 is the least aggressive. Grade 3 is the most aggressive.
Treatment
Treatment depends on the stage of the cancer, your health, and your wishes. Surgery is the most common treatment. A hysterectomy removes the uterus. The surgeon may also remove the tubes and ovaries.
Radiation therapy uses high-energy rays to kill cancer cells. Some women have it after surgery. This is often the case for stage 2 or 3 cancer, and for stage 1 cancer that is likely to come back or is grade 2 or 3. Chemotherapy or hormonal therapy may be used in some cases, most often for stage 3 and 4. Targeted therapy uses drugs to block the growth and spread of cancer cells. Tests show if it is right for your cancer.
The CDC says to ask for a referral to a gynecologic oncologist. You can also get a second opinion. Talk with your doctor before trying any complementary or alternative medicine. Many kinds have not been tested and may not be safe. Treatment may cause side effects. Follow-up tests continue from time to time after treatment ends.
When to see a doctor
Contact your provider for an appointment if you have any of these:
- Any bleeding or spotting after menopause begins.
- Bleeding or spotting after sex or douching.
- Bleeding that lasts longer than 7 days.
- Periods that come twice per month.
- New discharge after menopause has begun.
- Pelvic pain or cramping that does not go away.
Bleeding after menopause is a sign that should always be checked.
Call 911 or go to the emergency room if you have bleeding that will not stop, fainting, or sudden, severe pain.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review your symptoms and refer you to a gynecologic oncologist. They can also help you keep up with follow-up care.
Common questions
Is endometrial cancer the same as uterine cancer?
Not exactly. Endometrial cancer is the most common type of uterine cancer.
What are the first signs of endometrial cancer?
The signs include abnormal bleeding from the vagina, such as bleeding between periods or bleeding after menopause. Some women also have lower belly pain or pelvic cramping.
Is surgery the main treatment for endometrial cancer?
Yes. Surgery is the most common treatment for endometrial cancer. Some women also need radiation, chemotherapy, hormone therapy, or targeted therapy.
Is there a test to screen for endometrial cancer?
No. There is no effective screening test for endometrial cancer. Women with risk factors should be followed closely by their providers.
Sources
- MedlinePlus - Endometrial cancer
- National Cancer Institute - Treatment Endometrial Cancer
- CDC - Treatment of Uterine Cancer
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
