What is a common presenting symptom of endometrial carcinoma?

Vaginal bleeding is a common presenting symptom of endometrial carcinoma, particularly in postmenopausal women. Endometrial carcinoma often causes abnormal uterine bleeding due to the proliferation of cancerous cells within the endometrium, which leads to shedding of the uterine lining. This abnormal bleeding can manifest as heavy periods or bleeding between periods in women who are still menstruating, and as irregular spotting or bleeding in those who have stopped menstruating.

While severe abdominal pain, weight gain, and infertility can occur in various conditions related to the reproductive system, they are not as specific or common as vaginal bleeding when it comes to the early signs of endometrial carcinoma. Severe abdominal pain is typically associated with more advanced disease or other acute conditions, weight gain is a nonspecific symptom that can occur for various reasons unrelated to this specific cancer, and infertility could relate to many reproductive issues but is not a direct symptom of endometrial carcinoma. Thus, the prominence of vaginal bleeding in patients with this type of cancer makes it the standard presenting symptom to recognize in clinical practice.