Malignant tumour of the uterus. Cancers affecting the lining of the uterus (endometrium) are the most common cancers of the female reproductive tract. Risk factors include absence of pregnancy, early age of first menstruation (before age 12), late onset of menopause (after age 52), obesity, diabetes, and estrogen replacement therapy. Additional risk factors are a personal history of breast or ovarian cancer, age (over age 40), and a family history of uterine cancer. Whites are more likely to develop uterine cancer than are blacks. The major symptom is vaginal bleeding or discharge. Treatment may begin with simple or radical hysterectomy. Some uterine cancers are treated in part by hormonal therapy, radiation therapy, or chemotherapy.
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Abnormal bleeding from the uterus not related to menstruation. Most common in the first few years after menarche and as menopause approaches, it is thought to occur when malfunctioning ovaries reduce blood estrogen levels. A malfunctioning hypothalamus or pituitary gland may also cause hormonally induced uterine bleeding, as can birth-control pills or hormone-replacement therapy. Some tumours produce estrogen and can alter the menstrual cycle, causing bleeding. Tumours in the uterus often bleed easily. Other causes include injury to the uterus, stress, obesity, chronic illness, psychological problems, and blood and cardiovascular disorders. Treatment is directed toward the underlying cause.
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