Endometrial Cancer Symptoms and Side Effects: When to Call Your Doctor

If you've been diagnosed with endometrial cancer, you may wonder which symptoms and side effects to expect. Some warning signs are easy to miss or brush off. Here's what you shouldn't ignore and when to call your health care team.

About 90% of people with endometrial cancer have abnormal vaginal bleeding at diagnosis. Bleeding can also be a side effect of radiation treatment. After treatment, new bleeding can be a sign the cancer is back. You may have discharge (fluid from your vagina) along with the bleeding. If the discharge is watery, foul-smelling, or looks like pus, it may mean you have an infection. Tell your doctor, as the treatment for bleeding or discharge depends on the cause.

Chemo for endometrial cancer lowers your infection-fighting white blood cells in about 8 in 10 people, so infections take hold more easily. While a serious infection is less common, it can turn life-threatening. Wash your hands often and avoid people who are sick. Call your health care provider right away if you run a fever of 100.5 F (38 C) or higher, or have chills, a cough, or diarrhea. Don't take pain relievers first, as this can hide a serious problem.

More than half of people treated for gynecologic cancer have pain during sex. This can happen with endometrial cancer if radiation or surgery leaves your vagina dry, tender, or narrowed. Cancer treatment can also cause these changes if it triggers early menopause. It may feel awkward to bring up, but tell your doctor about deep pain or pelvic muscle spasms during sex, or a dull, throbbing pain after. This is common and treatable. Vaginal moisturizers, dilators, and pelvic floor therapy can help.

About 2 in 5 people with endometrial cancer lose weight without trying. This can come from the cancer itself or treatment side effects like nausea or taste changes. Losing too much can weaken your immune system and make the cancer harder to control. Try small, frequent meals rich in protein and calories, and ask about seeing a dietitian. Tell your doctor if the weight loss continues. It may mean the cancer is getting worse or has come back.

About 1 in 3 people with endometrial cancer report stomach or pelvic (lower belly) pain. You might also have gas, feel uncomfortably full, or notice bowel changes like constipation (when it's hard to poop) or diarrhea (loose poop). These can come from the cancer itself or from treatment such as radiation, chemotherapy (chemo), or surgery. Call your doctor if you notice any of these. Depending on the cause, your health care provider may change your treatment or give you medicine to ease the pain.

As many as 1 in 4 people treated for endometrial cancer develop lymphedema, a buildup of lymphatic fluid (which helps filter waste and fight infection). This happens if surgery or radiation damages your lymph system, leading to swelling, usually in the legs, genitals, or belly. Try to raise the area so fluid can drain. Your doctor can refer you to a therapist for lymphatic drainage massage and ask you to get compression garments, such as snug stockings or shorts, to keep fluid from building up.

Chemo for endometrial cancer can cause peripheral neuropathy in more than 1 in 5 people. This is damage to the nerves that carry signals between your brain and body. You might feel numbness, tingling, or burning pain in your hands and feet. Weakness, cramps, and balance problems are signs, too. Tell your health care team, even if symptoms come and go. They can adjust your chemo to protect your nerves and prescribe medicine for nerve pain to ease the discomfort.

About 1 in 7 people treated for endometrial cancer develop pelvic organ prolapse (when an organ drops into the vagina). Surgery to remove the uterus can weaken the tissues that support your pelvic organs. If prolapse affects the bladder, it's called a cystocele. You might pee more, strain to pee, or feel a bulge. Tell your doctor. Untreated, a cystocele can send urine back up and damage your kidneys. Pelvic floor exercises can help, but you may need surgery.

More than 1 in 10 endometrial cancers are found in women under 50. If you haven't reached menopause, surgery to remove your ovaries can trigger a sudden estrogen drop called surgical menopause. It can hit all at once, so symptoms like hot flashes, brain fog, mood changes, and trouble sleeping can feel more intense than natural menopause. Your health care provider may suggest hormone therapy or vaginal estrogen for dryness. They may refer you to a menopause specialist.

While you're in treatment for endometrial cancer, ask your health care team for a list of side effects that need urgent care. Share it with your loved ones and anyone helping care for you. Everyone is different, and symptoms vary from person to person. But call right away for red flags like heavy bleeding, a fever, or severe pelvic pain. You know your body best. If any new symptom worries you, don't wait until your next visit to tell your health care team.