Endometrial cancer involves the endometrium, the tissue that lines the uterus, and is by far the most frequently diagnosed type of uterine cancer. The most common symptom of endometrial cancer is abnormal vaginal bleeding, which includes bleeding after menopause, changes in bleeding before menopause, and bleeding in between periods. Other symptoms can include pain during sex, pelvic pain, abnormal discharge, and fatigue.

Frequent Symptoms

In general terms, the most common symptom of endometrial cancer is abnormal vaginal bleeding. Approximatley 90 percent of women have this symptom, according to the American Cancer Society.

Before Menopause

If you haven’t yet gone through menopause, abnormal vaginal bleeding includes:

  • Periods that are heavy and prolonged (lasting longer than seven days)Heavy spotting that occurs between periodsPeriods that occur every 21 days or soonerVaginal bleeding that occurs before and/or after sex

After Menopause

Any vaginal bleeding or spotting that starts a year or more after you’ve gone through menopause is considered abnormal and requires an evaluation by your healthcare provider. 

Other symptoms of endometrial cancer that can occur before or after menopause include:

Uterine cancer is not the only cause of vaginal bleeding after menopause. Fibroids, thyroid disorders, polyps, and hormone replacement therapy can also cause vaginal bleeding in post-menopausal women.

  • A watery or blood-tinged vaginal dischargePain during sexual intercourse

Symptoms that may occur in the later stages of cancer include:

  • Pelvic pain or cramping
  • Abdominal pain
  • Being able to feel a mass or tumor in your pelvis
  • Losing weight without trying
  • Fatigue
  • Bloating
  • Changes in bowel or bladder habits
  • Feeling full quickly

Complications

The only potential complication of endometrial cancer symptoms is anemia, a low red blood cell count. Symptoms of anemia include fatigue, weakness, cold hands and/or feet, irregular heartbeat, headaches, shortness of breath, pale or yellow-tinged skin, chest pain, and feeling dizzy or lightheaded. This kind of anemia is caused by an iron deficiency in your body as a result of blood loss.

Thankfully, it’s easily reversed through a diet that’s rich in vitamins and/or taking iron supplements, as well as by treating your endometrial cancer, which will stop the bleeding altogether. Speak with your oncologist before beginning any supplements.

When to See a Healthcare Provider

You should see your healthcare provider if you have any of the above-listed symptoms of endometrial cancer. They may turn out to indicate something else, but if you do have cancer, the earlier it’s detected, the better your outcome will be.

While you’re being tested for endometrial cancer, there is the risk of your uterus being perforated (torn) during the endometrial biopsy or dilation and curettage (D&C), but the chances of this are slim. The risk is slightly higher for women who have been through menopause or who have been pregnant recently.

Keep in mind that if you have any abnormal discharge at any stage of life, even if it’s not bloody, you may still have endometrial cancer and should see your healthcare provider. Discharge that isn’t bloody is associated with around 10 percent of cases of endometrial cancer.

If you’re experiencing heavy vaginal bleeding (soaking through one sanitary pad an hour), you should go to the emergency room.

Endometrial Cancer Doctor Discussion Guide

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Frequently Asked Questions

  • What are the early signs of endometrial cancer?
  • There are often few symptoms in the early stages of endometrial cancer. If they do occur, they may be non-specific and easily attributed to other causes. The most common early signs and symptoms include:Abnormal vaginal bleeding and spottingAbnormal vaginal dischargeChanges in the menstrual cycle
  • At what stage do symptoms of endometrial cancer commonly occur?
  • Because the symptoms are so non-specific in the early stages, around 30% of cases are diagnosed when the cancer is advanced (stages 3 and 4), typically causing pelvic pain, unintended weight loss, and a perceivable pelvic mass. Even so, the vast majority of cases are diagnosed during the early stages (stages 1 and 2).
  • What are the signs of metastatic endometrial cancer?
  • When endometrial cancer spreads (metastasizes), it will most often affect the bladder, rectum, vagina, ovaries, or fallopian tubes. Signs may include frequent or painful urination, pain during intercourse, rectal pain or discharge, and persistent pelvic cramping. There may also be generalized symptoms like fatigue, loss of appetite, and unintended weight loss.
  • What are the signs of endometrial cancer recurrence?
  • It depends on whether the recurrence is local, regional, or distant. While abnormal vaginal bleeding, vaginal discharge, pelvic pain, and a palpable mass are the most common signs, other frequent symptoms are urinary frequency or pain, changes in bowel habits, abdominal pain, unintended weight loss, persistent cough, chest pain, and deep vein thrombosis (DVT).

There are often few symptoms in the early stages of endometrial cancer. If they do occur, they may be non-specific and easily attributed to other causes. The most common early signs and symptoms include:

Because the symptoms are so non-specific in the early stages, around 30% of cases are diagnosed when the cancer is advanced (stages 3 and 4), typically causing pelvic pain, unintended weight loss, and a perceivable pelvic mass. Even so, the vast majority of cases are diagnosed during the early stages (stages 1 and 2).

When endometrial cancer spreads (metastasizes), it will most often affect the bladder, rectum, vagina, ovaries, or fallopian tubes. Signs may include frequent or painful urination, pain during intercourse, rectal pain or discharge, and persistent pelvic cramping. There may also be generalized symptoms like fatigue, loss of appetite, and unintended weight loss.

It depends on whether the recurrence is local, regional, or distant. While abnormal vaginal bleeding, vaginal discharge, pelvic pain, and a palpable mass are the most common signs, other frequent symptoms are urinary frequency or pain, changes in bowel habits, abdominal pain, unintended weight loss, persistent cough, chest pain, and deep vein thrombosis (DVT).