Menstrual symptoms
Tumors that produce hormones can cause disturbances in the menstrual cycle. For example, germ cell tumors such as Leydig Sertoli cell tumors, which produce masculinizing effects, can cause amenorrhea because of the androgen production in these tumors. Feminizing tumors such as granulosa cell tumors can cause menorrhagia, precocious puberty, and post-menopausal bleeding. A Brenner tumor causes abnormal uterine bleeding because it produces estrogen.
In cases of malignancies, abnormal post-menopausal uterine bleeding is seen in more patients due to the infiltrative nature of the tumor and can lead to ulcerations and bleeding.