Beyond recurrence detection: Treating the forgotten menopause in endometrial cancer survivors

Endometrial cancer is the most curable gynecological malignancy. Recurrence detection remains central to follow-up; however the management of treatment-induced morbidity remains comparatively underemphasized. As a result, menopausal symptoms remain under-recognized, despite their substantial impact on psychological wellbeing, sexual function, genitourinary health, cardiovascular risk, and bone health. This viewpoint highlights the imminent need to reposition hormonal and menopausal health as an important component element during endometrial cancer follow-up. Current evidence, including randomized and meta-analytic data, demonstrate that menopause hormone therapy (MHT) is safe for disease-free survivors of early stage, endometrioid carcinoma. Nevertheless, most clinicians remain reluctant to prescribe it, leaving many women untreated for preventable suffering. We propose a pragmatic, evidence-informed framework integrating symptom assessment, individualized MHT regimens, and multidisciplinary survivorship pathways. It is time to move beyond the ritual of surveillance towards compassionate, personalized survivorship care that restores hormonal health and places the quality of life at the Centre. For gynecologic oncologists, addressing the "forgotten menopause" is not optional but integral to evidence-based survivorship care.