How Endometrial Cancer Treatments Change Your Body
Endometrial cancer treatments can affect your body’s appearance and function. And both are closely related to our identity and how we see ourselves. When cancer treatment changes your body’s appearance, function, or both, it can affect how you see yourself socially, in your relationships, sexually, and even at work, says Jeanelle Folbrecht, PhD, a clinical health psychologist and the psychology chief at City of Hope in California.
Here are the most common changes that can affect body image in women who have undergone endometrial cancer treatment.
Surgical Effects
Surgery is often part of endometrial cancer treatment. Depending on the stage, it may involve removing the uterus, cervix, fallopian tubes, and the ovaries.
The physical scars from surgery may fade over time, but the emotional impact can feel deeply personal, says Barbara Buttin, MD, a gynecologic oncologist at City of Hope in Chicago. For many women, the uterus represents femininity, identity, and the ability to have children. “Losing [your uterus] can lead to feelings of grief, loss, or questions about womanhood and self-worth,” she says.
For Heide Spence, a single mother of two children who was diagnosed with stage 1 endometrial cancer at age 36 and treated with a hysterectomy, the physical and emotional effects were hard to process. “Without having a piece of me, losing an organ that allowed me to give life, was a struggle that I had to begin to wrap my brain around,” says Spence, now an Endometrial Cancer Action Network for African Americans (ECANA) ambassador. “None of my friends could understand. Some were still having babies.”
Hormonal Changes and Early Menopause
If you had an oophorectomy (removal of the ovaries) as part of treatment, and you hadn’t gone through menopause yet, you’ll enter surgical menopause When the ovaries are removed, your body immediately stops producing hormones (like estrogen and progesterone) that help regulate mood, temperature, and metabolism. This shift can feel sudden and intense.
Many women report hot flashes, weight gain, mood swings, and vaginal dryness after an oophorectomy, says Dr. Buttin. These symptoms can feel especially difficult if you’re coping with side effects from chemotherapy or radiation, she says. The sudden loss of hormones can also trigger emotional challenges like anxiety and depression, along with health concerns such as an increased risk for bone loss and heart disease.
Spence experienced sudden hormonal changes, which brought weight gain, mood swings, and depression. And being younger than most women with the diagnosis made her feel isolated, she says.
Weight Fluctuations
Weight changes are common during and after cancer treatment. Some women lose weight because of nausea, appetite changes, and fatigue. Others notice weight gain, especially if they’ve entered surgical menopause, are receiving medications like steroids, or are less active during recovery.
After treatment “I didn’t want to do anything. I just wanted to eat whatever was easy, including junk food, but it didn’t help my emotional or mental state,” says Spence. She recalls how the weight kept gaining, and the unpredictable mood swings made everything more difficult.
Hair Loss and Skin Changes
Chemotherapy and radiation can cause hair loss and skin dryness or darkening. “While some of these effects are temporary, they can have a lasting impact on how patients see themselves,” says Buttin. Many women describe feeling less confident, less attractive, and disconnected from their own bodies during this time, she says.
As Spence was managing weight gain, her long, healthy hair was something she held onto for confidence. But when she started oral chemotherapy and her hair began coming out in clumps, it felt like losing another piece of herself. “That became another battle,” she says.
Sexual Adjustments
For some, intimacy becomes another area affected by treatment. “Women with endometrial cancer often express fear of sexual interactions,” says Priscilla Chang, PsyD, a postdoctoral psychology fellow in the department of supportive care medicine at City of Hope.
Surgery, radiation, and chemotherapy can cause physical changes to the vagina and genital area, which can make sex uncomfortable or painful. Beyond the physical side, there’s often an emotional component: feeling less desirable, worrying about how your partner sees you, or just not feeling connected to your body in an intimate way anymore, Dr. Chang says.
Spence admits to feeling frustrated and even angry about how cancer changed her confidence. “I was single, and I kept thinking, Who’s going to want me now? I was already struggling to feel like myself and trying to navigate the weight changes,” she says.
She remembers the uncertainty of deciding how much to share about her diagnosis when dating. She had to figure out when and how to explain what happened to her and hope the other person didn’t run in the opposite direction, she says. “It took time, but I realized that what happened to me didn’t just change my body, it changed my life. It also gave me a new sense of purpose,” Spence says.
Living With a Urostomy or Colostomy
Some women need a urostomy or colostomy after treatment, which means wearing an external bag to collect urine or stool. This can feel like a huge loss of privacy and normalcy, Buttin says.
It’s a deeply personal adjustment that can affect confidence and social comfort. Learning to manage an ostomy takes time, and many women feel self-conscious about their body and are concerned about odor, leaks, and how it looks under clothing.
