Ovarian cancer (OC) is a group of diseases originating in the ovaries, which are complex organs serving both reproductive and endocrine functions. The short answer to whether ovarian cancer affects hormone levels is yes, the effect can be significant, but the specific hormonal change depends on the tumor’s type and origin. The ovaries are integral glands in the endocrine system, meaning any disruption by a cancerous growth can directly or indirectly alter the body’s hormonal balance. Understanding these hormonal shifts is important because they can lead to noticeable physical changes, sometimes providing the first clue that a problem exists.
The Normal Endocrine Function of the Ovaries
The healthy ovaries function as dynamic endocrine glands, primarily responsible for producing steroid hormones that regulate the menstrual cycle and support reproduction. They synthesize and release two main groups of hormones: estrogens, such as estradiol, and progestogens, most notably progesterone. These hormones act on the uterus, breasts, and brain, influencing a wide array of bodily processes, including bone health and cardiovascular function.
The ovaries also produce small but significant amounts of androgens, which are precursors to estrogen and contribute to female libido and overall well-being. This entire process is tightly regulated by hormones released from the pituitary gland in the brain, specifically Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). These pituitary hormones stimulate the ovarian follicles to mature, leading to the cyclical production of ovarian hormones and ovulation.
How Ovarian Tumors Directly Alter Hormone Production
The effect of an ovarian tumor on hormone levels depends on the type of cell from which the cancer originates. The most common ovarian cancers are epithelial tumors, which typically do not actively produce hormones. However, a small but important group, known as Sex Cord-Stromal Tumors, directly cause hormonal imbalances because they arise from the hormone-producing cells of the ovary.
Functional Tumors: The Direct Effect
These tumors are classified as “functional” because their cancerous cells retain the ability to synthesize and secrete hormones. Granulosa cell tumors, for instance, originate from cells that normally produce estrogen, resulting in dramatically elevated estrogen levels in the bloodstream. Conversely, Sertoli-Leydig cell tumors produce androgens, leading to an excess of hormones like testosterone. These tumors are relatively rare, but their hormonal effects are profound and distinct.
Non-Functional Tumors: The Indirect Effect
The most prevalent types of ovarian cancer, such as epithelial ovarian carcinomas, are considered non-functional, meaning the cancer cells themselves do not produce hormones. However, these large, rapidly growing tumors can still disrupt the endocrine balance indirectly through mass effect. As the tumor grows, it can physically destroy the surrounding healthy ovarian tissue responsible for normal, cyclical hormone production. This destruction of functional tissue can lead to a decrease in the body’s natural output of estrogen and progesterone.
Clinical Manifestations of Hormone Changes
The specific symptoms experienced by a patient are directly linked to the type of hormonal imbalance caused by the tumor. An overproduction of a hormone leads to symptoms of excess, while the destruction of healthy tissue results in symptoms of deficiency.
Estrogen Excess
Excess estrogen, commonly caused by a Granulosa cell tumor, can lead to several noticeable symptoms. In post-menopausal women, high estrogen levels can cause abnormal uterine or vaginal bleeding by stimulating the lining of the uterus. High estrogen can also promote a condition called endometrial hyperplasia, which is an excessive thickening of the uterine lining. In children, the tumor’s estrogen output can trigger precocious puberty, causing signs of sexual maturation and the onset of menstrual bleeding at an unusually young age.
Androgen Excess (Virilization)
Tumors that secrete excessive androgens, such as Sertoli-Leydig cell tumors, lead to symptoms of virilization. The most common sign is hirsutism, which is the growth of coarse, dark hair in areas typically associated with male hair growth (e.g., the upper lip, chin, and chest). As androgen levels continue to rise, the patient may experience other changes, including a deepening of the voice, male-pattern hair thinning or baldness, and increased muscle mass. The rapid onset of these symptoms often strongly suggests the presence of an androgen-secreting tumor.
Hormone Deficiency
In cases where a large epithelial tumor destroys the normal ovarian tissue, the resulting deficiency in estrogen and progesterone can manifest as symptoms similar to premature menopause. Patients may experience classic menopausal signs such as hot flashes, night sweats, and vaginal dryness. This decline in hormone production can also cause menstrual irregularities or amenorrhea (the complete cessation of the menstrual cycle). The body can no longer sustain the normal reproductive rhythm.