I just found out I have endometriosis, which my mother also has. She says endometriosis raises our risk of ovarian cancer, so I should have children early and then get a hysterectomy. What's the real story?
Answer From Tatnai Burnett, M.D.
It sounds like your mother jumped to the wrong conclusion. Although ovarian cancer occurs at higher rates in women with endometriosis, the overall lifetime risk is low to begin with. Some studies suggest that endometriosis increases that risk, but it's still relatively low.
Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis.
Endometriosis isn't a reason to have a hysterectomy unless you have significant symptoms that don't respond to less invasive therapies, and the uterus itself is causing pain or bleeding problems.
But endometriosis can be painful in premenopausal women and should be treated. Depending on the severity of your endometriosis, treatment options may include:
- Hormonal therapies, such as birth control pills, which help control the hormones that cause a buildup of endometrial tissue — and birth control pills are associated with a decrease in ovarian cancer risk.
- Conservative surgery to remove endometrial growths without removing your reproductive organs — with laparoscopic surgery in most cases, or traditional abdominal surgery in more-severe cases.
If you're worried about how endometriosis might affect your fertility, that's a different matter. Endometriosis does cause fertility problems for some women.
Normal conception, pregnancy and delivery are possible after conservative endometriosis treatment. But if you're having trouble conceiving, you may need to see a fertility specialist to explore your options for becoming pregnant.
With
Tatnai Burnett, M.D.
Jan. 12, 2021
- Muto MG. Risk-reducing bilateral salpingo-oophorectomy in women at high risk of epithelial ovarian and fallopian tube cancer. https://www.uptodate.com/contents/search. Accessed Oct. 31, 2018.
- Schenken RS. Endometriosis: Treatment of pelvic pain. https://www.uptodate.com/contents/search. Accessed Oct. 31, 2018.
- Lobo RA, et al. Endometriosis: Etiology, pathology, diagnosis, management. In: Comprehensive Gynecology. 7th ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Oct. 30, 2018.
- Dinkelspiel HE, et al. Does the presence of endometriosis affect prognosis of ovarian cancer? Cancer Investigation. 2016;34:148.
- Endometriosis. Office on Women's Health. https://www.womenshealth.gov/a-z-topics/endometriosis. Accessed Oct. 30, 2018.
- Hornstein MD, et al. Treatment of infertility in women with endometriosis. https://www.uptodate.com/contents/search. Accessed Oct. 30, 2018.
- Ovarian, fallopian tube, and peritoneal cancer: Risk factors and prevention. Cancer.net. https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/risk-factors-and-prevention. Accessed Oct. 30, 2018.
- Ovarian, fallopian tube, and primary peritoneal cancer prevention (PDQ) — Patient version. National Cancer Institute. https://www.cancer.gov/types/ovarian/patient/ovarian-prevention-pdq#section/all. Accessed Oct. 30, 2018.
- Oral contraceptives and cancer risk. National Cancer Institute. https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet. Accessed. Oct. 30, 2018.
- Torng P-L. Clinical implication for endometriosis associated with ovarian cancer. Gynecology and Minimally Invasive Therapy. 2017;6:152.
- Dunselman GA et al. ESHRE guideline: Management of women with endometriosis. Human Reproduction. 2014;29:400.
- Burnett TL (expert opinion). Mayo Clinic. Rochester, Minn. Dec. 2, 2018.