Menopause and Gynecological Malignancy

Abstract

Menopause is a consequence of biological aging. Menopause does not cause cancer, but the risk of developing cancer increase as a woman ages. Treatment of cancer can also cause premature menopause. Among the gynecological cancer, cervical cancer tops the list of common cancer. Postmenopausal women are prone to have persistent human papillomavirus (HPV) infection. There is no role of primary prevention of cervical cancer by vaccination in postmenopausal women. Secondary prevention by Paps smear only may provide false negative result as the cervix is often flushed with the vagina. So, scraping by Ayres spatula and using endometrial brush is necessary in these women. Unfortunately, symptoms of cervical cancer in postmenopausal women are nonspecific and associated with comorbidities. So, any symptom of cervical cancer in postmenopausal women should be properly evaluated. Ovarian cancer is the number one cancer of death among all gynecologic malignancies. Majority of the ovarian cancer in postmenopausal women present with vague symptom and have the advance stage at prevention. Currently, no reliable screening test is available. Yearly routine pelvic examination, transvaginal ultrasonography and serum CA-125 can be performed in selective high-risk women only. Endometrial cancer is the most common gynecologic cancer in the USA. Most endometrial carcinomas are diagnosed at an early stage and have a good prognosis. Though vulvar and vaginal cancer are rare malignancies, yet these are prevalent in postmenopausal women. Any postmenopausal women with long-term intense itching, pervaginal discharge or any ulcer of vulva or vagina should be evaluated properly.