“I Dismissed It as Menopause”—One Woman’s Endometrial Cancer Story

Julia G. told herself the heavy bleeding, aching hips and exhaustion were simply part of the aging process.

“I absolutely dismissed it as perimenopause,” says the mother from Strathmore, Alberta. “All my symptoms felt very much perimenopause related. I had achy hips, abnormal periods, so I thought, ‘I guess this is just what to expect.’”

But by the time Julia learned she had endometrial cancer, the disease had spread beyond her uterus.

Her story reflects just how easy it is for endometrial cancer to be mistaken for menopause or routine hormonal changes. Particularly for women in their 40s, 50s and 60s navigating perimenopause and post-menopause.

Endometrial cancer, which begins in the lining of the uterus, is one of the fastest-rising cancers affecting Canadian women. Although the disease can affect women at any age, risk increases after menopause and is also associated with factors including obesity, diabetes, irregular periods, never having been pregnant, and a personal or family history of hereditary cancers. That overlap is part of what makes the disease difficult to recognize, since symptoms are often dismissed as menopause or routine hormonal changes.

The very population most likely to develop endometrial cancer is also the most likely to mistake its warning signs for something else. According to a recent national survey of Canadian women aged 40 and older, 80 per cent of Canadian women lack baseline awareness of the disease, while 60 per cent confuse its primary warning signs with common menopausal changes or other pelvic conditions.

“The key red flag symptom is abnormal bleeding, and sometimes it’s not taken seriously enough because it’s viewed as part of the normal spectrum,” says Dr. Amit Oza, a medical oncologist at Princess Margaret Cancer Centre specializing in gynecologic cancers. “We often see women who’ve had symptoms for many months before seeking further investigation.”

Warning signs can include bleeding between periods, unusually heavy bleeding or any bleeding after menopause. By the time many women realize something is wrong, the disease may already be harder to treat.

For Julia, the turning point came unexpectedly while she was at work.

“I felt a pop and thought, what was that?” she recalls. “I ran upstairs to the bathroom and there was blood everywhere. I remember thinking that this was not normal. But I’d heard other women talk about having really heavy periods or ‘blowouts,’ so I still tried to rationalize it.”

The Delay Between Symptoms and Diagnosis

Even after Julia suspected something was wrong, getting answers proved difficult. Because she preferred a female gynecologist, she was placed on a lengthy waitlist.

“I waited a year and a half to get into a female gynecologist,” Julia says. “My family doctor told me this was just what happens sometimes, so I didn’t feel any urgency around it.”

Dr. Oza says persistent symptoms should never be ignored, particularly unusually heavy bleeding, post-menopausal bleeding, pelvic pain or bloating. If symptoms persist for weeks or months, or are accompanied by worsening discomfort, he recommends seeking further evaluation, which may include imaging, a gynecological referral or biopsy.

Meanwhile, Julia’s symptoms were getting worse.

An initial ultrasound showed her endometrial lining measured 10 millimetres. By the time she underwent another scan – nearly 24 months later—it had more than doubled to 23 millimetres, well above the threshold that typically prompts further evaluation in women with postmenopausal bleeding.

“When I Googled what that measurement meant, everything I read said it was likely cancer,” she says. “That’s when I realized something serious might be happening.”

The full reality became clear only after her hysterectomy.

“I was shocked to find out the cancer had spread to my lymph nodes outside the uterus,” Julia says. “That’s when everything changed. From that point on, I was in constant anxiety and fear.”

Why Early Detection Matters

According to Dr. Oza, approximately over 8,000 Canadian women are diagnosed with endometrial cancer each year. Like many cancers, outcomes are significantly better when the disease is caught early.

“In early-stage disease, surgery most often a hysterectomy is highly effective and frequently curative,” he explains. “That’s why early diagnosis is so important. As the cancer progresses to more advanced stages, treatment becomes more complex and includes integrating surgery, radiation, chemotherapy, and immunotherapy.”

One of the biggest shifts in endometrial cancer care is the move toward more personalized treatment based on the molecular makeup of a patient’s tumour. Researchers now understand that endometrial cancer includes several distinct subtypes, some of which respond especially well to immunotherapy, a treatment that helps the immune system recognize and attack cancer cells more effectively.

In some cases, immunotherapy is used alongside chemotherapy: chemotherapy helps shrink or weaken the cancer, while immunotherapy can help the body continue targeting remaining cancer cells.

“For some patients, those newer combinations are opening up treatment options that didn’t exist even a few years ago.”

Dr. Oza also notes that roughly 25 to 30 per cent of endometrial cancers contain a biomarker called Mismatch Repair Deficiency (MMRd), which may make certain patients more responsive to immunotherapy-based treatments.

Julia’s tumour carried the MMRd biomarker, making her eligible for a targeted treatment approach she describes as life-changing.

When Menopause Masks Something More Serious

For both Julia and Dr. Oza, one of the biggest barriers to earlier diagnosis is the tendency to normalize symptoms related to menstruation, menopause, and reproductive health.

“This type of cancer is not a pretty one,” Julia says. “But we need to talk about it, because every woman needs to know this information. I really want women to not be afraid to advocate for themselves.”

Dr. Oza agrees that abnormal bleeding—particularly bleeding after menopause—should never be dismissed as something women simply have to live with.

“If something is not sitting right and creating symptoms, it’s really important to talk about it with your healthcare provider and get investigated early,” he says. “If there is something going on, the earlier it’s detected, the better.”

That urgency matters because, according to Dr. Oza, many women wait months before seeking further evaluation, often assuming symptoms are hormonal or age-related.

“The time factor is really important,” he says. “I would much rather women act on symptoms within a matter of weeks rather than many months, which is what typically happens.”

For women over 40 experiencing unusually heavy bleeding, bleeding after menopause, pelvic pain or persistent bloating, experts say the most important thing is not to ignore symptoms or delay asking questions. Ask questions, push for answers, and trust yourself if something feels wrong. In many cases, early investigation can make a critical difference in treatment outcomes.

For more information and support, explore Ovarian Cancer Canada’s website dedicated endometrial cancer resource hub.