Ovarian cancer and the menopause

The menopause itself is not associated with an increased risk of developing cancer. However, the rates of many cancers, including ovarian cancer, do increase with age. In addition, some of the drugs used to manage menopausal symptoms may increase or decrease a person's cancer risk.

What is ovarian cancer?

Ovarian cancer is the fifth most common cancer among women in the UK. The UK has one of the highest rates of ovarian cancer in Europe - about 6800 women are diagnosed every year. Most cases are in women who are post-menopausal. Unfortunately, early ovarian cancer is hard to detect. Many cases of ovarian cancer are found after the cancer has spread to other organs. In these cases, the cancer is much more difficult to treat and cure.

What causes ovarian cancer?

The cause of ovarian cancer is not yet known. You have an increased risk of ovarian cancer if you:

• Have a family history of ovarian cancer
• Have never been pregnant
• Are over the age of 50, since the likelihood of developing ovarian cancer increases as you age

Studies show that women who have had children, who breastfeed, or who use oral contraceptives ( birth control pills) are less likely to develop ovarian cancer. These factors decrease the number of times a woman ovulates, and studies suggest that reducing the number of ovulations during a woman's lifetime may lower the risk of ovarian cancer, possibly because it reduces her overall exposure to oestrogen.

The menopause itself does not cause ovarian cancer, but studies have linked long term oestrogen replacement therapy (more than 10 years) to an increased risk of ovarian cancer. Women on oestrogen replacement therapy should discuss the risk and benefit of this treatment with their doctor.

What are the symptoms of ovarian cancer?

In its early stages, ovarian cancer has few symptoms. The first sign of ovarian cancer is usually an enlarged ovary. The ovaries are located deep within the pelvic cavity, so swelling may go unnoticed until it becomes more advanced.

Symptoms of more advanced ovarian cancer include:

• Swollen abdomen (caused by build-up of fluids produced by the tumour)
• Lower abdominal and leg pain
• Sudden weight loss or gain
• Change in bowel or bladder function
• Nausea
• Swelling in the legs

How can I protect myself from ovarian cancer?

While there is no definitive way to prevent ovarian cancer, there are steps you can take to reduce your risk and detect the disease in its early stages, increasing your chances of survival.

• Ask your doctor for a regular pelvic examination
• Report any irregular vaginal bleeding or abdominal pain to your doctor
• If you have close family members (mother, sister or daughter) with ovarian cancer, discuss your risk factors with your doctor
• Don’t use excessive talcum powder on or near the vagina; some research has linked talcum powder to an increased risk of ovarian cancer
• Eat a low-fat diet