Perimenopause, also known as “Menopausal transition” is the transitional phase before menopause. Menopause typically occurs in a woman between 45 and 52 years of age.
Menopause is defined as the cessation of menstruation for consecutive 12 months. Some women can experience menopause early (though rare), ≤40 years, known as Premature Menopause.
The period after menopause is known as postmenopausal period. Menopausal symptoms are more than just hot flashes and mood swings. It’s also a time when the risk of certain cancers, including breast, ovarian, endometrial, cervical, and colorectal cancer, increases due to hormonal fluctuations, age, and lifestyle factors.
The incidence of malignancy is still lower in the perimenopausal period than postmenopausal period, but still, it is a significant issue because cases are rising. But with awareness and proactive steps, women can protect themselves and take control of their health during these critical phases (both Perimenopause and Postmenopause).
Cancers Linked to Perimenopause & Postmenopause
During peri menopause, fluctuating hormone levels, especially estrogen, can increase a woman’s susceptibility to certain cancers. Breast cancer is one of the most common concerns, as estrogen can fuel the growth of some types of breast tumours. Triple-negative breast cancer cases are also there, and they are very aggressive.
Similarly, the incidence of endometrial (uterine) cancer risk rises during both peri menopause and post-menopause. Ovarian cancer risk is ~10-15% in pre and perimenopausal periods and higher in the postmenopausal periods.
During the perimenopausal period, mostly ovarian cancer belongs to ovarian malignancy of low malignant potential. It’s harder to detect early. Cervical cancer incidence is higher in the perimenopausal period than the postmenopausal period because of the withdrawal of estrogen during that period.
In addition, the risk of colorectal cancer increases after 45, making routine screenings especially important during this stage of life. Obesity is an added risk factor for hormonal fluctuation during the perimenopausal period.
Overall, Obesity, family history, and pre-existing co-morbidities [like Diabetes, hypertension, Dyslipidaemia, and history of polycystic ovarian syndromes (PCOS)] are important risk factors for malignancies in both the perimenopausal and postmenopausal period.
How Can Women Lower Their Cancer Risk?
1. Eat Smart: Fuel for Prevention
A healthy, balanced diet is your first line of defence.
- Fibre-rich foods like whole grains, legumes, fruits, and vegetables help regulate hormones (regulate estrogen metabolism and regulate insulin level) and reduce the risk of breast and colon cancer.
- Antioxidants found in berries, leafy greens, nuts, and seeds fight oxidative stress and inflammation and simultaneously boost immunity, reducing the risk of cancers.
- Healthy fats from sources like flax seeds, walnuts, and fatty fish support hormone balance, reduce inflammation and maintain stable blood sugar levels.
- Balanced Vitamins and Minerals intake (avoiding deficiency) reduce oxidative stress, inflammation and ensure genomic stability, and reduce the incidence of cancers.
Limit (better to avoid) red meat and processed meats and other food items, sugar, and refined carbs, all of which are linked to increased cancer risk.
2. Maintain a Healthy Weight
Weight gain during perimenopause is common but concerning. Excess body fat can increase estrogen levels and inflammation, oxidative stress, raising the risk of cancers.
Regular physical activity (150-300 mins a week of moderate aerobic exercise/ 75-100mins of vigorous aerobic exercise)—walking, swimming, cycling, with 2 days of strength training a week—combined with mindful eating, can help manage weight and lower cancer risk.
3. Limit Alcohol and Avoid Smoking
Even moderate alcohol consumption and occasional alcohol consumption both are linked to an increased risk of malignancies. Eliminating alcohol is a smart preventive move. Smoking is also a major risk factor for various cancers, including cervical, ovarian, and lung cancer. Quitting at any stage in life offers enormous health benefits.
4. Rethink HRT
Hormone Replacement Therapy (HRT) is often used to manage perimenopausal symptoms, but it may increase the risk of breast and endometrial cancer depending on the type and duration. Always consult your doctor to weigh benefits versus risks and explore non-hormonal options if needed.
5. Prioritize Regular Screenings
Early detection saves lives.
- Mammograms (from age 40) for breast cancer. If family history of breast and Ovarian cancers, screening should be started even earlier.
- Pap smears and HPV tests together (co-testing)/ PAP smear only/ HPV DNA testing only any of these three should be started as a screening test to prevent yourself from cervical cancer from post-marriage within 3 years of married life/ within 3 years after getting sexually active (from age 25 years).
- Colonoscopies (from age 45) for colorectal cancer (especially if a strong family history of malignancies is present)
Annual gynaecological check-ups are essential for monitoring reproductive health and discussing any symptoms.
Conclusion
Perimenopausal and Postmenopausal periods both are powerful times to prioritize your health.
With the right diet, active lifestyle, avoidance of harmful habits, and routine screenings, you can reduce your cancer risks and embrace this life stage with confidence and clarity.
Prevention starts with awareness, and a little self-care goes a long way.
