Hormonal status and menstrual function in women with endometrial cancer

Abstract

Relevance. Endometrial cancer is one of the most common malignant tumors of the female genital organs. Hormonal imbalance is considered one of the main etiological factors in the development of the disease. Long-term and uncontrolled exposure to estrogens, as well as progesterone deficiency, contribute to the proliferation of the endometrium and its subsequent malignant transformation. Menstrual dysfunction is also considered as a clinical indicator of these processes. It has been proven that such factors as early menarche and late menopause influence the development of endometrial cancer. Objective of the study. To study the features of hormonal status and menstrual function in patients with endometrial cancer, as well as to assess the impact of these indicators on the risk of developing the disease. Materials and methods of the study. From 2021 to 2024, a prospective study was conducted in the Oncogynecology Department of the National Cancer Center, including 120 women diagnosed with endometrial cancer. The stages of the study included: collecting the patients' anamnesis (menstrual history, reproductive history, age of menopause, cases of infertility and number of births). When assessing the menstrual function, the following were taken into account: age of menarche, type and duration of the menstrual cycle, intensity of bleeding during menstruation, age of menopause and cases of postmenopausal bleeding. For laboratory assessment of hormonal status, a study of estradiol (E2) and progesterone levels was performed. Results and discussion. Menstrual history: in 62% of patients, menarche began early, in 54%, episodes of anovulatory cycles were noted during the reproductive period. The average age of menopause in postmenopausal patients was 47-55 years. Postmenopausal bleeding was observed in 38%. Hormonal status: in premenopausal women, progesterone levels were significantly lower than normal (p < 0.05), while estradiol levels were higher than normal (p < 0.01). In postmenopausal women with elevated E2 levels (27%), endometrioid adenocarcinoma was more often detected. A statistically significant correlation was found between high E2/progesterone ratio and poorly differentiated tumors. Conclusion. Hormonal imbalance (high estrogen levels, low progesterone levels) and menstrual function characteristics (early menarche, late menopause) play an important role in the development of endometrial cancer. Regular monitoring of the hormonal profile and a thorough analysis of the menstrual history in women at risk are important for early diagnosis and prevention of the disease.

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