PCOS + Endometriosis Increase Your Risk of Endometrial Cancer

Did you know that there is a link between hormone imbalances like PCOS and endometriosis and an increased risk for cancer? Endocrine disruptors, which are chemicals that can interfere with the normal workings of the endocrine system, may be to blame. These chemicals can be found in everyday items like plastics and cosmetics, and they can have a serious impact on women's health. In this blog post, we will discuss the relationship between hormonal imbalances, infertility, and cancer risk. We will also explore how integrative medicine approaches can help reduce the risk of cancer in women with PCOS or other hormone imbalances.

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Can PCOS cause cancer?

In some studies, PCOS is associated with an increased risk of endometrial cancer. However, even large, peer-reviewed studies provide conflicting evidence (1).

For instance, in one large study, women with PCOS had an overall 17-fold higher risk of endometrial cancer than in women without PCOS (1).

But a Danish study did not find a higher prevalence of endometrial cancer in women with PCOS or androgen excess than in controls (2). And several studies that evaluated polycystic ovarian morphology have reported no association with endometrial cancer (3).

Related: Are there natural ways to treat and prevent breast cancer?

Even large studies have conflicting results

While some studies have suggested that the absence of ovulation, as can occur with PCOS, is linked with an increased risk of breast cancer, other studies have not shown an association.

This begs the question: why do some studies find a significant association with hormone-related issues and cancer—yet other studies find none? It’s likely due to the underlying cause of the hormone condition, and not the hormone condition itself.

Read more: The Integrative Guide to Infertility

PCOS and ovarian cancer

One population-based study of ovarian cancer suggested that women with PCOS had a 2.5-fold higher risk of ovarian cancer than women without PCOS (4). However, a meta-analysis showed that the risk of ovarian cancer was not significantly increased in women with PCOS (5). 

PCOS and breast cancer

In a long-term follow-up of 786 women who had received a diagnosis of PCOS, breast cancer was found to be the most common cause of death, which seems like a concerning statistic (6). However, many other studies have identified no significant association between PCOS and breast cancer (5).

Read: What is PCOS? Integrative Therapies + Fertility

Ovulation influences your risk of developing some kinds of cancer

A lack of ovulation, known as anovulatory cycles or anovulation, can cause the endometrium to build up and become thick. This thickening can sometimes lead to endometrial cancer.

The major reason PCOS increases the risk of endometrial cancer is the prolonged exposure of the endometrium to unopposed estrogen caused by anovulation (7). This prolonged exposure can cause endometrial hyperplasia and may lead to endometrial cancer.

Ovulation helps the body produce sufficient progesterone. Without ovulation, estrogen circulates unopposed, resulting in abnormal thickening of the uterine lining. 

Other risk factors for endometrial cancer are (8):

  • Obesity
  • Unopposed long-term estrogen use (i.e. oral contraceptives)
  • Infertility (possibly due to lack of ovulation)
  • Diabetes
  • High blood pressure 

Other hormone-related issues can also increase the risk of developing endometrial cancer, such as estrogen dominance and endometrial hyperplasia. In the meantime, if you’re not ovulating, or have irregular periods, you may want to speak with your doctor about your individual risks.

Read more: 7 Signs of Low Progesterone

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Estrogen dominance and breast cancer

Prolonged exposure to high amounts of estrogens may increase the risk for some cancers. This issue, known as estrogen dominance, occurs when there’s an imbalance in the ratio of progesterone to estrogen, high exposure to xenoestrogens in the environment, or poor estrogen metabolism in the liver or digestive system.

An analysis of nine different studies suggested that having high levels of the estrogen doubles the risk for breast cancer, especially for women post-menopause (9).

There are ways to reduce estrogen dominance and promote healthy estrogen metabolism.

Endometriosis associated with increased risk of cancer

Endometriosis may increase the risk of ovarian cancer, and other conditions, but does not appear to increase endometrial cancer risk.

Endometriosis is an inflammatory disease characterized by endometrial tissue growing outside the uterus. It often causes debilitating pelvic pain and fertility struggles. Although largely benign, endometriosis does have cancer-like features. Endometriosis is also linked to an increased ovarian cancer risk (10). 

Despite some findings linking endometriosis to increased cancer risk, researchers urge that any increase in ovarian or endometrial cancer risk remains similar to that of the general population. It’s estimated that 1 in 76 women will develop ovarian cancer in her lifetime, while the lifetime risk of ovarian cancer among women with endometriosis is fewer than two women in 100 (10). 

It’s an increase—but a very small one. This small increase in risk should reassure women with endometriosis that their lifetime ovarian cancer risk is quite low, and is negligibly different from women who don’t have endometriosis. 

Read more: 10 Signs You May Have Estrogen Dominance

Endometrial hyperplasia

Endometrial hyperplasia can be the culprit behind heavy menstrual cycles, and in some cases, cancer. 

Excess estrogen and/or the absence of sufficient progesterone (frank or relative estrogen dominance) causes the cells in the lining of the uterus to grow thicker than normal. When the endometrium becomes abnormally thick, this can result in a condition known as endometrial hyperplasia

Some types of endometrial hyperplasia are more likely to cause cancer

Some types of endometrial hyperplasia are more likely to develop into cancerous cells. There are different types of endometrial hyperplasia:

  • Simple endometrial hyperplasia 
  • Complex endometrial hyperplasia 
  • Simple atypical endometrial hyperplasia
  • Complex atypical endometrial hyperplasia

Complex atypical hyperplasia is rare, but it is also mostly considered a precancerous condition.

Endometrial hyperplasia doesn’t always result in cancer, and there are other hormone-related factors you can improve to reduce your risk of developing breast, ovarian, uterine, and endometrial cancers.

Various lifestyle, dietary, and metabolic risk factors may influence your overall risk of developing certain types of cancer.

Inflammation – PCOS is linked with greater chronic inflammation, which is a root cause of various chronic diseases.

Excess body fat – Because fat cells (called adipocytes) are capable of producing estrogen, this elevation in estrogen exposure may fuel the growth of cancers that use estrogen to grow.

Insulin resistance – PCOS has a high prevalence of insulin resistance, which makes it more likely you’ll experience metabolic dysregulation and cardiovascular risk factors.

Oral contraceptives – Long-term use of hormonal birth control pills can also affect risk of cancer in some people.

Related: The Integrative Guide to Perimenopause

Reduce your risk of cancer if you have PCOS

Whether you have a hormonal condition or just want to optimize your hormone health, there are things you can do to be proactive and become aware of your current risk factors for various hormone-related problems.

Get regular exams with your integrative practitioner

Keep track of your health with regular hormone testing, nutritional evaluation, and a personalized plan tailored specifically to your needs. The proper function of your body’s chemical messengers is paramount to your overall health. 

All new patient appointments include 3-hour visit times and a detailed history and exam.

Eat a balanced diet high in anti-inflammatory foods

Build healthy hormones with quality proteins, nutrient-dense plant foods such as leafy greens and other vegetables, and fats rich in omega-3s like fish, nuts & seeds, olive, coconut, and avocado.

A healthy diet can stack the deck in your favor to reduce xenoestrogens, improve antioxidants, and reduce inflammation.

Leverage the right supplements like berberine and inositol

Dietary supplements can help fill the gaps in your diet, as well as optimize specific hormone processes. Supplements that may be helpful include:

  • Inositol to support healthy progesterone and thyroid function
  • Berberine to promote healthy blood sugar and insulin sensitivity
  • Calcium d-glucarate to support estrogen detoxification

Browse all hormone health supplements in the shop.

Stay active and maintain a healthy weight.

Regular exercise is important for hormone balance. One study found that women who worked out for 12 weeks developed not only better muscle strength and flexibility, but an improvement in estrogen levels as well (12). 

Consider IV therapy

With environmental toxins, nutrient-depleted diets, and a hefty dose of stress, most of our bodies aren’t getting what they need on a cellular level. This can lead to a host of chronic illnesses stemming from reduced immune function, antioxidant status, and more.

At CentreSpringMD, we offer IV drip packages ranging from a recovery-boosting Recharge Drip, to an antioxidant Beauty Drip. 

Work with an integrative provider if you have PCOS or endometriosis

So, what does this all mean for women with PCOS or endometriosis? While the research on the links between PCOS, endometriosis, and cancer is ongoing, it’s important to be proactive about your health if you have one of these conditions. Diet, exercise, stress management, and other lifestyle modifications are key to mitigating risk factors. Additionally, early diagnosis is crucial for managing any precancerous changes. Integrative therapies like acupuncture and IV therapy may also be helpful in supporting hormone balance. Ultimately, by taking a proactive approach to your health and partnering with an experienced practitioner, they can help you create a personalized prevention plan.

Resources 

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181615/
  2. https://pubmed.ncbi.nlm.nih.gov/22583042/ 
  3. https://pubmed.ncbi.nlm.nih.gov/19554665/ 
  4. https://pubmed.ncbi.nlm.nih.gov/8841217/ 
  5. https://pubmed.ncbi.nlm.nih.gov/24688118/
  6. https://pubmed.ncbi.nlm.nih.gov/9674665/
  7. https://pubmed.ncbi.nlm.nih.gov/23624028/
  8. https://pubmed.ncbi.nlm.nih.gov/19561777/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314432/
  10. https://pubmed.ncbi.nlm.nih.gov/25765863/
  11. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33049-0/fulltext
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862258/

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