Quick answer. Endometrial cancer is cancer of the womb lining, and its key warning sign is abnormal vaginal bleeding – especially any bleeding after the menopause. Any postmenopausal bleeding should be checked by a doctor promptly, as early diagnosis is often very treatable.
Endometrial cancer, also called uterine cancer, develops in the lining of the womb (the endometrium). Its most important feature is that it usually announces itself early through abnormal vaginal bleeding, particularly bleeding after the menopause. In Singapore it is one of the more common gynaecological cancers, and rising rates of obesity and diabetes are recognised factors.
The encouraging point is that because abnormal bleeding tends to appear early, endometrial cancer is often picked up at an early, treatable stage when women act on the symptom. This guide explains what endometrial cancer is, its symptoms and risk factors, how it is diagnosed and treated, and the clear rule that any postmenopausal bleeding needs prompt medical assessment.
At a glance
| Situation | Pattern | Action |
|---|---|---|
| After the menopause | Any vaginal bleeding at all | See a doctor promptly to investigate |
| Before the menopause | Bleeding between periods | Get it checked if persistent or unusual |
| Before the menopause | Very heavy or prolonged periods | Review with a doctor |
| Any age | Bleeding after sex | Have it assessed |
| Any age | Unusual or blood-stained discharge | See a doctor |
What is endometrial cancer?
Endometrial cancer is cancer that starts in the endometrium, the inner lining of the womb. It is the most common type of cancer affecting the body of the uterus. Because the womb lining sheds and bleeds, a cancer there often causes abnormal bleeding relatively early, which is why it is frequently found at a stage when treatment works well.
It is most common after the menopause but can occur earlier. In Singapore it is among the more frequently diagnosed cancers in women, and its links to weight, diabetes and hormonal factors make awareness important. The single most useful thing to remember is that bleeding after the menopause is never normal and should always be checked.
Symptoms & signs
The main symptom is abnormal vaginal bleeding. Signs to watch for include:
- Any vaginal bleeding after the menopause – even light spotting
- Bleeding between periods, or unusually heavy or prolonged periods before the menopause
- Bleeding after sex
- An unusual or blood-stained vaginal discharge
- Pelvic pain or discomfort, usually a later symptom
Many causes of abnormal bleeding are not cancer, but because bleeding can be an early sign of endometrial cancer, it should always be assessed rather than assumed harmless.
Causes & risk factors
Endometrial cancer is linked to lifetime exposure of the womb lining to the hormone oestrogen. Recognised risk factors include:
- Being overweight or obese
- Type 2 diabetes
- Reaching the menopause later, or starting periods early
- Never having been pregnant
- Certain hormone treatments, such as oestrogen-only hormone therapy or the breast cancer medicine tamoxifen
- Polycystic ovary syndrome (PCOS)
- A family history or inherited conditions such as Lynch syndrome
Having risk factors does not mean cancer will develop, and managing weight and diabetes is good for general health as well.
How it's diagnosed
When abnormal bleeding is reported, a doctor will examine you and arrange tests to look at the womb lining, which may include:
- A pelvic ultrasound, often transvaginal, to measure the thickness of the womb lining
- An endometrial biopsy, a sample of the womb lining taken in clinic
- Hysteroscopy, where a thin camera is passed into the womb to look directly and take samples
- Further imaging such as MRI or CT if cancer is confirmed, to assess its extent
These tests also help identify the many non-cancerous causes of abnormal bleeding.
Treatment options
Treatment is planned by a specialist team based on the type and stage and your overall health. It often includes:
- Surgery, commonly removal of the womb (hysterectomy), usually with the ovaries and fallopian tubes, and assessment of nearby lymph nodes
- Radiotherapy, sometimes used after surgery or as a main treatment
- Chemotherapy in more advanced cases
- Hormone therapy in selected situations
When found early, endometrial cancer is often very treatable, which is why prompt assessment of abnormal bleeding is so valuable. Your team will explain the plan suited to your situation.
When to see a doctor & which specialist
See a doctor promptly if you have any vaginal bleeding after the menopause – even a single episode of light spotting. Also seek assessment for bleeding between periods, unusually heavy periods, bleeding after sex, or a persistent unusual discharge. These symptoms are often not cancer, but they should always be checked.
Seek urgent care for very heavy bleeding with dizziness, fainting or signs of significant blood loss, and call 995 if you are severely unwell. Otherwise, do not delay a routine appointment for postmenopausal bleeding.
Endometrial cancer is managed by gynaecological and cancer specialists. You can find a specialist through our directories of oncologists in Singapore and gynaecologists in Singapore.
What to expect at the appointment
When you see a doctor about abnormal bleeding, you will be asked about your periods, when the bleeding started, any menopause history, and the medicines you take. A pelvic examination and a transvaginal ultrasound are common first steps, and an endometrial biopsy may be taken in clinic. Try to note the dates and pattern of any bleeding beforehand, and bring a list of your current medicines, including any hormone therapy.
Questions to ask your doctor
- What is the likely cause of my bleeding, and what tests do I need?
- If a biopsy or hysteroscopy is needed, what does it involve?
- If cancer is found, what stage is it and what are my treatment options?
- How will treatment affect my daily life and recovery?
Costs and financing in Singapore
Investigations such as ultrasound and biopsy, and treatments such as surgery, are available at public hospitals with subsidies for eligible patients. MediSave can usually be applied towards hospitalisation and surgery within the set withdrawal limits, and MediShield Life provides protection against larger inpatient bills. Ask your care team about the costs and assistance schemes that apply to you.
Common questions
Is bleeding after the menopause always cancer?
No. Many causes are not cancer, such as a thinned womb lining or polyps. But because bleeding can be an early sign of cancer, any postmenopausal bleeding should always be checked promptly.
Can endometrial cancer be cured?
When found early, it is often very treatable, frequently with surgery alone. This is why acting quickly on abnormal bleeding is so valuable.
Related guides
- Best Oncology Clinics in Singapore — our editorial shortlist
- oncology clinics directory
- Myasthenia gravis
- Hyperparathyroidism
- Cushing's syndrome
- Ovarian cancer
- Bartholin's cyst
Sources
- NHS – Womb (uterus) cancer
- Mayo Clinic – Endometrial cancer
- HealthHub Singapore
- Singapore Cancer Society
Part of our Cancer care & screening guides · Browse all health topics