International Women’s Day is a reminder that women’s health deserves open, evidence-led conversations, especially around menopause. As hormone levels shift in your 40s and 50s, questions about cancer risk often follow. Does menopause increase cancer risk? Is hormone replacement therapy safe? The answers are more nuanced than headlines suggest. Understanding how hormones influence the body after menopause helps women make confident, informed decisions.
Menopause is a natural stage of life, yet there is a reluctance to have open discussion about it. This leaves women uncertain and unsure about what symptoms to expect, how to manage them, or how safe different treatments really are.
The relationship between menopause, hormones, and cancer risk is complex and influenced by many factors, including the type of cancer, lifetime hormone exposure, and individual health history. This article will clear up how menopause affects the body, explain what hormone replacement therapy (HRT) involves, and explore what the evidence says about its connection to cancer.
How Menopause Changes Hormone Levels
Menopause is the natural decrease in the reproductive hormones oestrogen and progesterone1. This process marks the end of ovulation and menstrual periods, which can happen for many reasons, including age, surgery (removal of ovaries), or some cancer treatments. You are considered perimenopausal until you have had 12 consecutive months without a period2.
The hormonal changes during this time can be dramatic and cause several symptoms including3:
- Hot flushes
- Poor sleep
- Mood changes
- Palpitations
- Headaches and migraines
- Muscle and joint pain
- Dry or itchy skin
- Urinary tract infections
- Sensitive teeth and gums
Perimenopause and menopause can be turbulent stages in a woman’s life. As the body adjusts to changing hormone levels, symptoms can be eased with HRT. However, HRT has been linked in some studies to a small increase in the risk of certain cancers and other conditions, though this is still being actively researched4.
Does Menopause Itself Increase Cancer Risk?
Age is one of the strongest risk factors for several types of cancer5. The longer we live, the greater the likelihood that we will be exposed to carcinogens. These are substances that increase cancer risk, such as ultraviolet (UV) radiation, alcohol, and tobacco smoke6.
Many cancers become more common after the age of 506, which often coincides with perimenopause or menopause. However, this does not mean menopause itself causes cancer7.
The stress of the sudden drop of oestrogen seen during early menopause (before 45–50) slightly increases the risk of cervical, ovarian, and uterine cancers according to a study of over 8,000 women8. But overall, the end of ovulation reduces lifetime oestrogen exposure, ultimately lowering risks for these hormone-sensitive cancers over time8,9.
Breast Cancer and Menopause
The risk of breast cancer increases steadily with age.
Around 80 per cent of breast cancer occurs in women over 5010. Oestrogen helps breast cells grow and divide during puberty, but when levels stay high for decades, excessive cell division can raise the risk of tumour growth9. Women who start their periods early or reach menopause later have the longest oestrogen exposure12.
As we age, our bodies also become less efficient at spotting dysfunctional cells. If these keep dividing, they can accumulate and form tumours11.
HRT and Breast Cancer Risk
HRT is used to manage menopausal symptoms, replacing oestrogen and sometimes progesterone. Though effective, they come with their own risks depending on the type of treatment and how long you take them13.
The combined HRT (oestrogen and progestogen) carries a small increased risk of breast cancer with long-term use, while oestrogen-only HRT has a slightly lower risk14. For both treatments, risk increases the longer you take them, which declines once you stop15. The absolute risk of cancer is relatively small and is outweighed by HRT's benefits for symptom control16.
Ovarian Cancer and Hormones
Ovarian cancer risk is less clearly linked to reproductive hormones than breast cancer.
Combined HRT carries a small increased ovarian cancer risk with long-term use7, while oestrogen-only HRT appears neutral or slightly protective17. Unlike breast cancer, the risk of ovarian cancer doesn't increase the longer you take HRT, and may last a bit longer after stopping18.
Similar to breast cancer, the absolute risk is relatively small and is outweighed by HRT's menopausal symptom control19,20.
Endometrial (Womb) Cancer Risk
Oestrogen stimulates cell division, thickening the lining (endometrium) of the uterus (womb) to prepare for pregnancy21. With oestrogen-only HRT, the cells are constantly encouraged to divide, thickening the endometrium and increasing cancer risk. This therapy is only offered to women who have had a hysterectomy22,23.
The progesterone in combined HRT offsets these effects by encouraging the uterus to shed this lining every month, similar to a period. This maintains uterine health and reduces the risk of cancer24.
The Role of Lifestyle After Menopause
Weight management is especially important after menopause.
Fat tissue produces extra oestrogen, raising risks for breast, womb, and ovarian cancers25. Even modest weight loss (5-10 per cent of body weight) can significantly lower the risk of these cancers26.
- Eat well: A balanced diet rich in vegetables, fruits, and whole grains supports weight control and overall health27.
- Exercise: Regular physical activity cuts cancer risk by 20-30 per cent across multiple types, partly by helping control weight and balancing hormones28.
- Drink less: Alcohol increases breast cancer risk, 1 drink a day raises risk ~7-10 per cent29.
- Quit smoking: Tobacco increases the risk of lung, mouth, and other cancer risks30.
Should Women Avoid HRT Because of Cancer Risk?
The decision to use HRT is a personal one. For many women, short-term use is considered low risk.
Factors which may influence the choice to use them or not may include:
- Symptom severity
- Age
- Personal risk factors
- Family history
It’s important to discuss the potential benefits and risks with your GP to make an informed choice that suits your needs.
Early Detection Still Matters
In the UK, NHS breast screening is offered to people aged 50 to 71, every 3 years. Staying aware of breast changes remains important at all ages31.
There is currently no national screening programme for ovarian or uterine cancer, so it’s vital to see your GP if symptoms like unusual bleeding, bloating, or pelvic pain appear.
Advanced imaging services like Ezra’s MRI scans can give insights into the ovaries and uterus, allowing for early signs of cancer to be spotted before symptoms emerge.
Conclusion
Menopause itself does not directly cause cancer. Age and lifetime hormone exposure have a greater influence on cancer risk. HRT carries both risks and benefits that vary between individuals, while lifestyle factors also play an important role in shaping postmenopausal health.
Treatment decisions should always be personal. This International Women’s Day is a reminder that open, informed conversations about women’s health are essential.
Ezra’s MRI can screen for early signs of cancer or 500+ other conditions in 14 organs, all in a fast, painless session. Book your Ezra Scan today.
Understand your risk for cancer with our 5 minute quiz.
Our scan is designed to detect potential cancer early.
References
1. Yang JL, Hodara E, Sriprasert I, Shoupe D, Stanczyk FZ. Estrogen deficiency in the menopause and the role of hormone therapy: integrating the findings of basic science research with clinical trials. Menopause N Y N. 2024;31(10):926-939. doi:10.1097/GME.0000000000002407
2. NHS. Menopause. nhs.uk. October 23, 2017. Accessed March 4, 2026. https://www.nhs.uk/conditions/menopause/
3. NHS. Menopause - Symptoms. nhs.uk. October 23, 2017. Accessed March 5, 2026. https://www.nhs.uk/conditions/menopause/symptoms/
4. Gompel A, Simcock R. Menopausal hormone treatment and breast cancer. Lancet Diabetes Endocrinol. 2026;14(3):259-274. doi:10.1016/S2213-8587(25)00394-8
5. Cancer Research UK. Age and cancer | Cancer Research UK. Accessed March 5, 2026. https://cancerresearchuk.org/about-cancer/causes-of-cancer/age-and-cancer
6. Laconi E, Marongiu F, DeGregori J. Cancer as a disease of old age: changing mutational and microenvironmental landscapes. Br J Cancer. 2020;122(7):943-952. doi:10.1038/s41416-019-0721-1
7. Sanserino K. Menopausal hormone therapy and breast cancer: risk and management. Curr Opin Obstet Gynecol. 2026;38(2):117-122. doi:10.1097/GCO.0000000000001094
8. Abulajiang Y, Liu T, Wang M, Abulai A, Wu Y. The influence of menopause age on gynecologic cancer risk: a comprehensive analysis using NHANES data. Front Oncol. 2025;15:1541585. doi:10.3389/fonc.2025.1541585
9. Travis RC, Key TJ. Oestrogen exposure and breast cancer risk. Breast Cancer Res BCR. 2003;5(5):239-247. doi:10.1186/bcr628
10. Cancer Research UK. Cancer Stats Data Hub. Accessed March 5, 2026. https://crukcancerintelligence.shinyapps.io/CancerStatsDataHub/_w_334fcf9fc0eb4bd2bf17d3bd8ef02497/?_inputs_&nav=%22Incidence%20Breakdowns%20and%20Trends%22&app_select_CancerSite=%22Breast%22&app_select_Country=%22United%20Kingdom%22
11. Dodig S, Čepelak I, Pavić I. Hallmarks of senescence and aging. Biochem Medica. 2019;29(3):030501. doi:10.11613/BM.2019.030501
12. Anderson KN, Schwab RB, Martinez ME. Reproductive Risk Factors and Breast Cancer Subtypes: A Review of the Literature. Breast Cancer Res Treat. 2014;144(1):1-10. doi:10.1007/s10549-014-2852-7
13. NHS. About hormone replacement therapy (HRT). nhs.uk. July 21, 2023. Accessed March 5, 2026. https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/about-hormone-replacement-therapy-hrt/
14. Cancer Research UK. Does HRT increase risk of cancer? | Cancer Research UK. Accessed March 5, 2026. https://cancerresearchuk.org/about-cancer/causes-of-cancer/hormones-and-cancer/does-hormone-replacement-therapy-increase-cancer-risk
15. Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of breast cancer: nested case-control studies using the QResearch and CPRD databases. The BMJ. 2020;371:m3873. doi:10.1136/bmj.m3873
16. NHS. Benefits and risks of hormone replacement therapy (HRT). nhs.uk. July 21, 2023. Accessed March 5, 2026. https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/benefits-and-risks-of-hormone-replacement-therapy-hrt/
17. Josefson D. Oestrogen only HRT increases risk of ovarian cancer. BMJ. 2002;325(7357):180.
18. Collaborative Group on Epidemiological Studies of Ovarian Cancer. Menopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies. Lancet Lond Engl. 2015;385(9980):1835-1842. doi:10.1016/S0140-6736(14)61687-1
19. Menopausal Hormone Therapy—Risks, Benefits and Emerging Options: A Narrative Review - PMC. Accessed March 5, 2026. https://pmc.ncbi.nlm.nih.gov/articles/PMC12652300/
20. Xiang H, Wang L, Sun L, Xu S. The risk of ovarian cancer in hormone replacement therapy users: a systematic review and meta-analysis. Front Endocrinol. 2024;15:1414968. doi:10.3389/fendo.2024.1414968
21. Parisi F, Fenizia C, Introini A, et al. The pathophysiological role of estrogens in the initial stages of pregnancy: molecular mechanisms and clinical implications for pregnancy outcome from the periconceptional period to end of the first trimester. Hum Reprod Update. 2023;29(6):699-720. doi:10.1093/humupd/dmad016
22. Cancer Research UK. Risks and causes of womb cancer. Accessed March 5, 2026. https://www.cancerresearchuk.org/about-cancer/womb-cancer/risks-causes
23. Furness S, Roberts H, Marjoribanks J, Lethaby A. Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. Cochrane Database Syst Rev. 2012;2012(8):CD000402. doi:10.1002/14651858.CD000402.pub4
24. Kim JJ, Chapman-Davis E. Role of Progesterone in Endometrial Cancer. Semin Reprod Med. 2010;28(1):81-90. doi:10.1055/s-0029-1242998
25. Kuryłowicz A. Estrogens in Adipose Tissue Physiology and Obesity-Related Dysfunction. Biomedicines. 2023;11(3):690. doi:10.3390/biomedicines11030690
26. Anazco D, Acosta A, Cathcart-Rake EJ, D’Andre SD, Hurtado MD. Weight-centric prevention of cancer. Obes Pillars. 2024;10:100106. doi:10.1016/j.obpill.2024.100106
27. Cancer Research UK. Why diet is important. Accessed March 5, 2026. https://www.cancerresearchuk.org/about-cancer/coping/physically/diet-problems/why-diet-is-important
28. Spanoudaki M, Giaginis C, Karafyllaki D, et al. Exercise as a Promising Agent against Cancer: Evaluating Its Anti-Cancer Molecular Mechanisms. Cancers. 2023;15(21):5135. doi:10.3390/cancers15215135
29. McDonald JA, Goyal A, Terry MB. Alcohol Intake and Breast Cancer Risk: Weighing the Overall Evidence. Curr Breast Cancer Rep. 2013;5(3):10.1007/s12609-013-0114-z. doi:10.1007/s12609-013-0114-z
30. Cancer Research UK. How does smoking cause cancer? | Cancer Research UK. Accessed March 5, 2026. https://cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/how-does-smoking-cause-cancer
31. NHS. Who breast screening is for. nhs.uk. November 3, 2025. Accessed February 2, 2026. https://www.nhs.uk/tests-and-treatments/breast-screening-mammogram/who-breast-screening-is-for/
