Why does a young girl get endometrial cancer? How to detect endometrial cancer early? The girl was 25 years old and visited the clinic because of vaginal bleeding for 2 months and ultrasound suggesting endometrial lesions. She had never had regular menstruation since she was 13 years old. She either did not have menstruation or would bleed for more than a month and often took herbs to regulate her menstruation. She and her family could not accept the diagnostic curettage at first because the girl was not married although she was sexually active. After diagnostic scraping, the endometrial pathology results were: complex endometrial hyperplasia with atypical hyperplasia and localized malignancy. Why did she develop endometrial cancer at such a young age? What are the high-risk factors for endometrial cancer? The endometrium is affected by estrogen and progesterone. Progesterone plays a role in the endometrial tissues to counteract estrogen, and the lack of progesterone counteracts the endometrium to make endometrial lesions, initially endometrial hyperplasia, and then gradually develop into endometrial cancer. What are the conditions that produce sustained estrogenic action in the absence of progesterone action? Which women are prone to endometrial lesions and even endometrial cancer? The following is a brief description of the risk factors for endometrial cancer. Obesity: premenopausal obesity is mainly related to metabolic dysregulation and anovulation, because patients do not ovulate, which also lacks the secretion of progesterone, which makes the endometrium under the action of a single estrogen that lacks progesterone antagonism for a long time, and then carcinogenesis occurs. In postmenopausal obese women, androgens (androstenedione) secreted by adrenal glands can be converted into estrogens (estrone) by the action of enzymes (aromatase) in adipose tissues, and the more adipose tissues, the stronger the conversion ability, and the higher the plasma level of estrone, which is the main estrogen in the body of postmenopausal women, and the long-term influence of endometrium by estrogen without progestin antagonism can also lead to endometrial carcinogenesis . Diabetes: Diabetic patients have metabolic abnormalities, and the risk of endometrial cancer in these patients is three times higher than that in those with normal blood sugar. Hypertension: Patients with hypertension have an increased chance of developing endometrial cancer. Obesity, diabetes and hypertension are called the “triad of endometrial cancer”. Some scholars suggest that coronary atherosclerotic heart disease is also related to endometrial cancer, which may be caused by hypothalamic-pituitary-adrenal dysfunction and metabolic abnormalities, and also related to high-calorie and high-fat diet and lack of exercise, so some people suggest that endometrial cancer is a kind of “civilization disease” in contemporary society. “disease of civilization”. Reproductive endocrine disorders: including amenorrhea, irregular vaginal bleeding, infertility, polycystic ovary syndrome (PCOS), etc. All these diseases and manifestations are related to abnormal ovarian endocrine function, focusing on abnormal ovulation (sporadic ovulation, anovulation). In the absence of ovulation, endometrium lacks progesterone antagonism, and endometrial hyperplasia and even cancer can occur under the effect of long-term single estrogen. Some patients with reproductive endocrine disorders (e.g., PCOS, etc.) are also associated with lifestyle changes in recent years. Therefore, a healthy lifestyle is especially important to reduce the occurrence of endometrial cancer. Exogenous estrogen: With the continuous improvement of people’s living standard and awareness of health care, many menopausal women go to hospitals for consultation and apply sex hormone supplementation therapy after getting relevant knowledge, but there are also women who apply estrogen drugs on their own. These women simply apply estrogen without doctor’s guidance and regular checkups, which will greatly increase the risk of endometrial cancer. In hormone supplementation therapy combining estrogen and progestin, if the protective effect of progestin is sufficient, it is relatively safe for the endometrium even if applied for a long time. Can endometrial cancer be prevented? ① For patients with anovulatory conditions such as amenorrhea and infertility, they should seek timely medical consultation for necessary progestin treatment. Both progestin and oral contraceptives can counteract the effect of estrogen and prevent endometrial hyperplasia and even cancer; ② People’s living standard has improved and some unhealthy lifestyles such as high-calorie and high-fat diet and lack of exercise should be adjusted in time, which can not only reduce the chance of endometrial cancer, but also ③ If you have a history of irregular vaginal bleeding, you should go to the hospital in time and undergo diagnostic scraping or hysteroscopy if necessary; by timely detection of single estrogen effect without progesterone counteracting and treating it accordingly, you can reduce the chance of endometrial cancer. In case of vaginal bleeding, the prognosis of patients can be significantly improved by early detection and treatment through timely consultation.