Healthy Soch
With more than 28,000 new cases of corpus uteri cancer estimated in India in 2024, doctors urge women not to ignore bleeding or spotting after menopause
India
healthysoch
Chandigarh, October 31, 2026:
Women usually feel relaxed when they reach menopause. It is the time when they suffer no more typical bleeding, pain, or cramps. But is it true? No, menopause may mark the end of menstrual periods, but for some women, bleeding or spotting can occur even months or years after their last period. While postmenopausal bleeding can be caused by benign conditions such as thinning of the vaginal or uterine lining, polyps, or infections, doctors emphasise that any bleeding after menopause should be evaluated promptly to rule out serious conditions, including uterine cancer.
According to the latest report from GLOBOCAN 2024 estimates, India recorded around 28,308 new cases of corpus uteri cancer and 6,362 deaths in 2024. Corpus uteri cancer refers to cancers arising in the body of the uterus, with endometrial cancer being the most common type. Unlike some cancers that can remain silent for a long time, endometrial cancer commonly causes abnormal vaginal bleeding. Approximately 90% of women diagnosed with endometrial cancer have postmenopausal bleeding at presentation.
Understanding the warning symptoms women should not ignore
Most of the cancers may remain unnoticed in their early stages, but endometrial cancer often presents with identifiable warning symptoms. Some symptoms include a few drops of blood or spotting, pink, brown or blood-stained vaginal discharge, bleeding after sexual intercourse, a single episode of bleeding, recurrent light bleeding, and heavier vaginal bleeding. It is also important to remember that bleeding does not automatically mean cancer. Atrophic changes of the vagina or endometrium, polyps and other benign
conditions are common causes.
Studies have found that around 90% of women diagnosed with endometrial cancer experience postmenopausal bleeding, making it an important symptom for women to recognise. However, postmenopausal bleeding does not automatically mean cancer. Not all women evaluated for this symptom have malignancy, but the cause cannot be determined without appropriate medical assessment.
“Women should not ignore bleeding simply because it is light, occurs only once or appears as spotting. There are several benign causes of postmenopausal bleeding, but it is important to identify the underlying reason. A timely consultation with a gynaecologist and appropriate investigations can help rule out serious conditions which requires intense monitoring and evaluations”, says Dr Sunitha Mahesh, Medical Director and Senior Consultant – Reproductive Medicine and Maternal Fetal Medicine, Milann – Fertility and
Birthing Hospital, Bengaluru.
What are the risk factors?
The risk of endometrial cancer increases with age. Age is an important risk factor, but several other factors can increase risk, which include overweight or obesity, particularly increasing weight after adulthood, Type 2 diabetes and metabolic syndrome, Polyendocrine Metabolic Ovarian syndrome (PMOS), long-term exposure to oestrogen without adequate progesterone, certain hormone therapies after menopause, tamoxifen use, previous endometrial hyperplasia or atypical hyperplasia, early onset of periods or late menopause, never having been pregnant, a strong family history of endometrial or colorectal cancer,
Lynch syndrome, an inherited cancer-predisposition syndrome.
Women may experience different forms of abnormal bleeding, including light spotting, pink or blood-stained discharge, bleeding after intercourse, or heavier-than-usual bleeding. Some women may also experience pelvic discomfort or pressure.
How to Diagnose
When a woman reports with postmenopausal bleeding, doctors may recommend a pelvic examination and transvaginal ultrasound. Depending on the findings and individual risk factors, an endometrial biopsy may be advised to examine the uterine lining for abnormal or cancerous cells.
Early evaluation is important because endometrial cancer is frequently diagnosed at an early stage, when treatment can be more effective. Treatment depends on the type and stage of the cancer and may include surgery, radiation therapy, chemotherapy, hormone therapy, or other systemic treatments in selected patients.
“The encouraging aspect of endometrial cancer is that many women present with bleeding while the disease is still at an early stage. The challenge is ensuring that women do not delay seeking medical advice. When diagnosed early, treatment can often be highly effective, with surgery forming the mainstay of treatment for many patients. The treatment plan, however, is individualised based on the cancer’s type, grade and stage,” says Dr Vijay Kumar Srinivasalu, Senior Consultant – Medical Oncology, Sakra World Hospital,
Bengaluru.
The “4 mm rule”
Women may hear that an endometrial thickness of 4 mm or less means that everything is normal. Earlier American College of Obstetricians and Gynecologists (ACOG) guidance used an endometrial thickness of ≤4 mm as a highly reassuring finding in women with an initial episode of postmenopausal bleeding. However, the 2026 ACOG update has changed the approach, recommending a combination of ultrasound and tissue sampling in most women with postmenopausal bleeding. Persistent or recurrent bleeding should not be dismissed simply because an ultrasound appears reassuring. Therefore, women should not self-
interpret an ultrasound report as a “cancer clearance.”
Preventing Uterine cancer
Not every case can be prevented, but several measures can reduce risk. Adipose tissue can increase oestrogen exposure, which can stimulate the endometrium, therefore, regular exercising to keep oneself physically active. Good control of blood sugar, blood pressure and metabolic health is important because obesity, diabetes and metabolic syndrome are associated with increased endometrial cancer risk. Discuss hormone therapy with your physician, if needed. Keep a track on the family history.
Postmenopausal bleeding should not be normalised as a part of ageing or dismissed because it is painless or occurs only once. Not every episode indicates cancer, but every episode deserves attention. Consulting a gynaecologist at the first sign of unexplained bleeding can help identify the cause early and, when necessary, enable timely treatment.
