A woman holds an empty picture frame in front of her face and smiles.Many of my patients come to see me about symptoms and health issues they are experiencing, but I make it a point to help them recognize when they are at risk for something they don’t yet have.

This is especially true if they have increased risk factors for specific diseases or various health problems. There are changes they can make to help prevent these issues.

One of my patients, who I’ll call Judy, was faced with some life-changing decisions she needed to make, so we sat down and talked about what was happening in her life.

Judy’s mom had recently been diagnosed with end-stage endometrial cancer, and Judy wanted to know how she could shape her own future to be different from her mom’s. We first looked at Judy’s current health and how she was handling perimenopause.

For the most part, she was taking her perimenopausal symptoms in stride, but she struggled with weight gain (especially around her middle) and she was a smoker. She was afraid to quit smoking, fearing that she would gain even more weight.

As with all of my menopause patients, we discussed what she wanted her Picture of Self to look like at a specific point in her future and what she had planned to help her achieve her goals.

Before we discussed the changes Judy could make, we talked about some of the well-defined risk factors of endometrial cancer that she can control.

Excess estrogen increases the risk of endometrial cancer because it induces the lining of the uterus (endometrium) to grow. When this growth occurs unchecked, there is a risk of abnormal or cancerous development. Progesterone acts as a natural balance by stabilizing the endometrium and keeping it from growing out of control.

Excess estrogen can occur for two reasons: the levels can increase naturally during perimenopause, or there may be too much “unopposed” estrogen if you take estrogen-containing medications without balancing them with progesterone.

Low-dose combination oral contraceptives and appropriate doses of hormone therapy can help prevent endometrial cancer by controlling the level of circulating hormones and thus the growth of the lining of the uterus. Progesterone-releasing IUDs also help control the growth of the endometrium and decrease the likelihood of abnormal growth.

Finally, Judy and I discussed some lifestyle habits that can make a significant impact on her risk of developing endometrial cancer.

Smoking increases the risk of developing many cancers—another great reason to quit! Weight loss can help to decrease the risk, because estrogen, like many hormones, is stored long-term in body fat. Therefore, decreasing the body fat reduces the excess estrogen in your body. Other healthy changes you can make include increasing your physical activity, and eating a diet low in saturated fats and high in fruits and vegetables.

After talking with Judy, she was much more optimistic about her future. She has a clear understanding of her specific risk factors, specifically her smoking and central obesity. She has also regained a sense of control, and by making healthy choices, she is continuing to work toward her goals.