Did You Get Your Period Early? It Could Affect Your Cancer Risk

There are certain cancer risk factors you can't control, like your age, race, or sex assigned at birth. How old you were when you started to menstruate - called menarche - is another one of those factors you have no say over.

But if you got your period at an earlier age, your risk of seven different cancers is higher than if you first menstruated later in adolescence.

Those seven cancers are bladder, breast, colon, endometrial, liver, lung, and melanoma.

Most girls start to menstruate when they are just shy of 12 years old.

"The earlier you start your period, the more cumulative estrogen exposure you'll have throughout your life," says Heather Thompson Mackey, DNP , an oncology nurse practitioner and the senior director of cancer prevention and early detection at the Prevent Cancer Foundation . Each additional year before menarche was associated with a lower risk of these seven cancers.

There's still a lot that researchers don't understand about that extra estrogen exposure - not to mention other potential theories about why menarche has anything to do with cancer. But the current thinking is that because tissues all over your body have estrogen receptors, estrogen can fuel the types of cell mutations that may lead to these seven cancers. "Some types of cancers can grow and spread because estrogen stimulates more production," Mackey says.

While you can't travel back in time and change your experience of puberty, there are concrete steps you can take to limit your risk of these seven cancers.

Bladder Cancer

While it's still not a proven fact that estrogen fuels bladder cancer, there are estrogen receptors in the bladder and also in some bladder cancer tumors.

Reduce your risk: If you currently smoke, bladder cancer risk is another compelling reason to quit, Mackey says. In fact, it's the most significant risk factor you have control over here, according to the American Cancer Society (ACS) : Smoking causes about half of all cases of bladder cancer, and if you smoke you're around three times more likely to develop it than if you don't.

Breast Cancer

The association with lifetime exposure to estrogen is strongest with breast and endometrial cancers, Mackey says. Certain types of breast cancers essentially feed on estrogen, according to the ACS .

Reduce your risk: If you carry extra weight, aim for a healthier number on the scale. "Body fat will make estrogen," says Therese Bartholomew Bevers, MD , the medical director of the cancer prevention center at the University of Texas MD Anderson Cancer Center in Houston. A woman with a leaner body composition has less estrogen circulating than a woman with more body fat, she explains, and so - just as if you started menstruating earlier - you're exposed to more estrogen over time.

Alcohol use is also linked to a higher risk of breast cancer, even at moderate amounts, so consider scaling back or quitting, the ACS advises. And while it won't reduce your risk of breast cancer, regular screening mammograms can help you and your doctor catch any lumps early, which often makes cancer easier to treat, Mackey says. (Depending on your overall risk of breast cancer, your doctor will typically recommend you start getting mammograms between age 40 and 50.)

Colon Cancer

Less is understood about the link between colon cancer and hormone exposure, but there are estrogen receptors in the colon. Colorectal cancer has also been increasing in people 55 and under, Mackey says. "We're studying it more to try to figure out why," she says, and so far, early research points to diet.

Reduce your risk: Limit the amount of red meat, processed meat, and grilled food you eat if you're concerned about your colon cancer risk, as all three are linked to higher chances of developing the disease, according to the ACS .

And don't forget about screening: Make sure you're getting regular colonoscopies - starting at age 45, according to the ACS - which can detect and remove precancerous lesions before they ever become cancer, Mackey says.

Endometrial Cancer

Rates of endometrial cancer - or cancer of the lining of the uterus - have been growing over the last decade, according to the ACS , and while more research is needed, that increase may be related to body weight, Mackey says.

Indeed, research shows the link between age at menarche and endometrial cancer risk was stronger among women with more body fat.

Reduce your risk: There is no screening test for endometrial cancer, Mackey says, but lifestyle factors you can control that might reduce your risk include maintaining a healthy weight and using birth control pills or an IUD, according to the ACS .

Liver Cancer

Liver cancer rates have tripled since the 1980s, according to the ACS , but it's not entirely clear why, and the link with how old you were when you got your first period is similarly fuzzy, Dr. Bevers says. There are estrogen receptors in the liver, though.

Reduce your risk: Consider scaling back on how much alcohol you drink. "I think we've done a great job of making people aware of the risks of tobacco, but it's a little bit harder with alcohol," Mackey says. That said, "with liver cancer in particular, heavy alcohol use is strongly associated, so you may want to avoid drinking altogether."

Lung Cancer

More research is needed to fully understand the relationship between lung cancer and estrogen exposure, especially when it comes to the various subtypes of lung cancer.

Reduce your risk: Smoking is the leading risk factor for lung cancer, according to the ACS . If you're worried about your risk and you currently smoke, make a plan to quit . Do your best to limit your exposure to secondhand smoke, too, and to workplace chemicals like radon or asbestos.

Melanoma

It's not well-understood why exposure to estrogen might increase your chance of developing this serious skin cancer, Bevers says, but there are estrogen receptors in your skin.

Reduce your risk: "Pay attention to your skin," Bevers says, especially to any spots, moles, or lesions that look suspicious or change. Be diligent about sunscreen and scheduling regular skin checks with your primary care doctor or dermatologist, she adds.

Ultimately, when you started menstruating is just one of many potential risk factors for cancer, and it's certainly not a guarantee of a future diagnosis, Mackey says. Instead, let this knowledge motivate you to change what you can. "It makes it even more important for you to take a hard look at those factors you can control."

Otherwise, you don't need to do anything differently. This link isn't strong enough to warrant earlier or more frequent screening, for example, but you can, Bevers says, "be empowered to lead a healthy lifestyle" with this information.

The Takeaway

If you started menstruating early, you may have a higher risk for certain cancers, such as breast and endometrial, because of longer lifetime exposure to estrogen. While you can't change when you started your period, healthy habits like not smoking and maintaining a balanced diet can help you manage your risks. Remember, regular screenings and preventive care are key steps in staying proactive about your health.

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Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

1. Fuhrman BJ et al. Association of the age at menarche with site-specific cancer risks in pooled data from nine cohorts. Cancer Research . October 15, 2021.
2. Trends and Patterns in Menarche in the United States: 1995 through 2013–2017. Centers for Disease Control and Prevention . September 10, 2020.

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Walter Tsang, MD, is a board-certified medical oncologist, hematologist, and lifestyle medicine specialist. Inspired by the ancient Eastern philosophy of yang sheng ("nourishing life"), Dr. Tsang has developed a unique whole-person oncology approach that tailors cancer care and lifestyle recommendations to each patients' biopsychosocial-spiritual circumstances. He partners with patients on their cancer journeys, emphasizing empowerment, prevention, holistic wellness, quality of life, supportive care, and realistic goals and expectations. This practice model improves clinical outcomes and reduces costs for both patients and the healthcare system.

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