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Irregular menses are a risk factor for ovarian cancer

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According to a new study, women who experience irregular menses are at increased risk for ovarian cancer. The findings were presented on April 9 at the American Association for Cancer Research, which was held at the San Diego Convention Center, by lead researcher Barbara Cohn, PhD, MPH, director of Child Health and Development Studies at the Public Health Institute in Berkeley, California.

Dr. Cohn and her team defined irregular menses as menstruation that occurs at greater than five week intervals or cycles in which an ovum was released (an anovulatory cycle). They defined normal menstruation as periods that occurred at 21 to 35 days. The study group comprised 14,000 women who had delivered at least one child. The investigators found that, compared to women whose menses were regular, women who experienced irregular menses at age 26 were approximately twice as likely to die from ovarian cancer in their 60s. The increased risk was also found if other risk factors for ovarian cancer were taken into account, such as age, weight, and infertility medication.

The cause of ovarian cancer is currently unknown; It is the ninth most common cancer that occurs among women. About 22,240 new cases of ovarian cancer occur in the US each year. Certain factors increase the risk of ovarian cancer. These include: age (over the age of 55); obesity; hormone replacement therapy (HRT; some studies have suggested that women who use hormone replacement therapy after menopause may have a slightly increased risk of ovarian cancer; infertility; certain infertility drugs such as Clomid; history of breast or colon cancer; family history (first-degree relatives, such as mother, daughter, sister, of a woman who has had ovarian cancer are at risk for developing the disease); and a family history of breast or colon cancer.

Factors that may reduce the risk of ovarian cancer include: healthy diet (high in fruits, vegetables, grains, and low in saturated fat); maintaining a healthy body mass index (BMI); birth control pills; pregnancy and breastfeeding; and oophorectomy (surgical removal of ovaries if you are at high risk for ovarian cancer. Research studies have reported that certain genes (e.g., BRCA1 and BRCA2 mutations) are responsible for increasing the risk of ovarian and breast cancer. Genetic counseling can tell you whether you have one of these gene mutations. If your family history suggests that you may have one of these gene mutations, you might want to talk to your physician about genetic testing.

Take home message:

Often, when ovarian cancer is at an early stage, symptoms are not present. Thus, women with a history of irregular menses or other risk factors should have a thorough gynecologic exam once a year. An ultrasound exam should be done at this exam because it can image ovarian enlargement and, if present, it can determine the degree of suspicion for ovarian cancer. For example, a single fluid-filled cyst with no other signs of malignancy is a low risk situation. Women at increased risk for ovarian cancer should discuss undergoing a bilateral oophorectomy (removal of both ovaries) with their gynecologist

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