1.Clinical use of oral contraceptives.
Journal of the Korean Medical Association 2013;56(4):321-325
Since oral contraceptives (OCs) were first introduced in 1960, they have been used as a highly effective contraceptive method for over 50 years. Besides the prevention of pregnancy, they provide various non-contraceptive benefits. Well-known non-contraceptive benefits related to menstruation include reduction of dysmenorrhea and heavy menstrual bleeding. In addition, many women see improvements in acne and symptoms from premenstrual syndrome/premenstrual dysphoric disorder with OC use. In addition, OCs also can be used for the management of endometriosis or polycystic ovarian syndrome, and have also been reported to decrease the risk of ovarian and endometrial cancer. Consequently, many women may choose to use OCs in light of their non-contraceptive benefits. These non-contraceptive benefits can encourage women to select OCs as an useful option for contraception, improving their quality of life, and even providing public health benefits. Therefore, clinicians should be familiar with OCs and able to provide detailed information regarding their non-contraceptive benefits. The purpose of this article is to review the current evidence for the non-contraceptive benefits of OCs.
Acne Vulgaris
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Contraception
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Contraceptives, Oral
;
Dysmenorrhea
;
Endometrial Neoplasms
;
Endometriosis
;
Female
;
Hemorrhage
;
Humans
;
Light
;
Menstruation
;
Polycystic Ovary Syndrome
;
Pregnancy
;
Public Health
;
Quality of Life
2.Clinical Characteristics of Gynecologic Problems During Childhood in the Korean Population
Haewon CHOI ; Sung Eun KIM ; Nae Hyun LEE ; Dong-Yun LEE ; DooSeok CHOI
Journal of Korean Medical Science 2023;38(37):e279-
Background:
This study analyzed common gynecologic problems among Korean patients younger than ten years.
Methods:
We performed a retrospective analysis of medical records of patients younger than ten years who visited the Pediatric and Adolescent Gynecology Clinic at Samsung Medical Center between 1995 and 2020.
Results:
Among the 6,605 patients who visited the Pediatric and Adolescent Gynecology Clinic, data from 642 patients younger than ten years were analyzed in this study. The most common chief complaint was genital anomalies, followed by increased vaginal discharge and abnormal findings on clinical examinations. The most common disease entity was agglutination of the labia minora, which was commonly discovered incidentally during routine screenings. Vulvovaginitis, the second most common disease, was identified by symptoms of vaginal discharge, pruritus, and vaginal spotting. Neoplasm, issues with vaginal bleeding, and “other causes” were additional categories of gynecologic problems.245 patients (38.2%) were referred from primary care sources, 175 patients (27.4%) sought care directly at the clinic, 169 patients (26.3%) were referrals from the institution’s pediatric department, and the remainder were referrals from other departments.
Conclusion
This study provides information about the gynecologic problems most frequently encountered in pediatric patients. The study provides helpful insight for primary care physicians into the proper management and timing of referrals for these gynecologic problems of pediatric patients.
3.Perceptions and Knowledge of Women Regarding Contraception and Current Trends in Contraceptive Use in Korea
Kyong Wook YI ; Seul Ki KIM ; Dong-Yun LEE ; Sa Ra LEE ; Hyosun SHIN ; DooSeok CHOI
Yonsei Medical Journal 2022;63(11):999-1006
Purpose:
This study aimed to investigate the perceptions and behaviors of Korean women of reproductive age in regards to contraception counseling.
Materials and Methods:
The study sample was collected in Korea and comprised 1011 women aged 20–44 years and 150 obstetrics and gynecology (OB/GYN) doctors. Participants completed online questionnaires assessing their current methods of contraception, knowledge of and satisfaction with contraceptive methods, and willingness to learn about and use other contraceptive methods.
Results:
Women used condoms (74.2%), natural methods (cycle control or withdrawal, 52.4%), and combined oral contraceptives (COCs) (36.9%) more frequently than long-acting reversible contraception (LARC) methods, such as hormone-releasing intrauterine system (IUS) (4.5%), copper-intrauterine devices (3.3%), and subdermal implants (1.4%). Although the proportion of women who used LARC was low, those who used hormone-releasing IUS or subdermal implants reported high levels of satisfaction. The findings revealed discordant results between women and OB/GYN doctors regarding the initiation and quality of information provided by doctors about contraception and overall satisfaction with counseling. Most women (83.1%) expressed a desire to have more information about various contraceptive methods. More than 60% of women reported a willingness to use LARC, such as hormone-releasing IUS or subdermal implants, when provided with detailed information in counseling.
Conclusion
The majority of Korean women are familiar with condoms and natural methods, but lack knowledge about alternative contraceptive methods, including LARC. Women who used LARC reported higher levels of satisfaction than those who used other methods.
4.Menopausal Hormone Therapy and Progression of Non-Alcoholic Fatty Liver Disease in Postmenopausal Women: A 12-Month Study
Sung Eun KIM ; Ji-Song MIN ; Saemi LEE ; Dong-Yun LEE ; DooSeok CHOI
Journal of Menopausal Medicine 2021;27(3):s5-
Objective:
This study was conducted to evaluate the effects of menopausal hormone therapy (MHT) on the progression of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women.
Materials and Methods:
We included 515 women who received MHT for 12 months. Changes in NAFLD was evaluated by ultrasonography (progressiono progression) were compared before and after 12 months of MHT based on the route of estrogen administration (transdermal/oral). In addition, changes in NAFLD according to estrogen dose and type of progestogen were evaluated.
Results:
Baseline characteristics did not differ between patients who received transdermal (n=82) vs. oral (n=433) MHT. After 12 months of transdermal MHT, the prevalence of NAFLD decreased from 23.2% to 18.3% and the progression of NAFLD was observed in 3.7% patients, but this was not significantly different from those taking oral MHT. NAFLD progression was more common in women who had NAFLD at baseline and who received on oral MHT regimen compared to transdermal regimen (12.4% vs. 5.3%), however, differences were not statistically significant. In the oral MHT group, progression of NAFLD was significantly more common in standard-dose than low-dose (P=0.039). There was no significant difference in NAFLD progression according to the type of progestogen in patients using standard dose of estrogen.
Conclusion
Our findings suggest that the route of estrogen administration and oral dose of estrogen might affect progression of NAFLD in women with NAFLD at baseline.
5.Perceptions and Knowledge of Women Regarding Contraception and Current Trends in Contraceptive Use in Korea
Kyong Wook YI ; Seul Ki KIM ; Dong-Yun LEE ; Sa Ra LEE ; Hyosun SHIN ; DooSeok CHOI
The Korean Journal of Gastroenterology 2022;63(11):999-1006
Purpose:
This study aimed to investigate the perceptions and behaviors of Korean women of reproductive age in regards to contraception counseling.
Materials and Methods:
The study sample was collected in Korea and comprised 1011 women aged 20–44 years and 150 obstetrics and gynecology (OB/GYN) doctors. Participants completed online questionnaires assessing their current methods of contraception, knowledge of and satisfaction with contraceptive methods, and willingness to learn about and use other contraceptive methods.
Results:
Women used condoms (74.2%), natural methods (cycle control or withdrawal, 52.4%), and combined oral contraceptives (COCs) (36.9%) more frequently than long-acting reversible contraception (LARC) methods, such as hormone-releasing intrauterine system (IUS) (4.5%), copper-intrauterine devices (3.3%), and subdermal implants (1.4%). Although the proportion of women who used LARC was low, those who used hormone-releasing IUS or subdermal implants reported high levels of satisfaction. The findings revealed discordant results between women and OB/GYN doctors regarding the initiation and quality of information provided by doctors about contraception and overall satisfaction with counseling. Most women (83.1%) expressed a desire to have more information about various contraceptive methods. More than 60% of women reported a willingness to use LARC, such as hormone-releasing IUS or subdermal implants, when provided with detailed information in counseling.
Conclusion
The majority of Korean women are familiar with condoms and natural methods, but lack knowledge about alternative contraceptive methods, including LARC. Women who used LARC reported higher levels of satisfaction than those who used other methods.
6.Effects of different add-back regimens on hypoestrogenic problems by postoperative gonadotropin-releasing hormone agonist treatment in endometriosis.
Dong Yun LEE ; Hyang Gi PARK ; Byung Koo YOON ; Dooseok CHOI
Obstetrics & Gynecology Science 2016;59(1):32-38
OBJECTIVE: To compare the efficacy of different add-back regimens on hypoestrogenic symptoms during postoperative gonadotropin-releasing hormone (GnRH) agonist treatment in endometriosis patients. METHODS: This prospective cohort study included reproductive-aged women who underwent conservative laparoscopic surgery for ovarian endometriosis and received add-back therapy during a 6-month course of GnRH agonist therapy after surgery. Participants received one of four different add-back regimens: 1 mg of estradiol valerate, 2.5 mg of tibolone, or a combination of 1 mg of estradiol and 2 mg of drospirenone or 0.5 mg of norethisterone acetate. Changes in quality of life, hypoestrogenic symptoms, and bone mineral density were compared according to add-back regimens. RESULTS: A total of 57 participants completed a 6-month course of GnRH agonist and add-back therapy. All components of quality of life did not differ across groups. However, within the same treatment group, social relationship factors decreased significantly with estradiol valerate and tibolone alone, and environmental factors decreased significantly with estradiol valerate alone. Menopausal Rating Scale score did not change significantly, but the incidence of hot flushes significantly decreased with a combination of estradiol and norethisterone acetate. Bone mineral densities at the lumbar spine declined significantly after treatment in all groups except with a combination of estradiol and norethisterone acetate. CONCLUSION: This preliminary study suggests that an add-back regimen containing estradiol valerate and norethisterone acetate may have better efficacy in terms of quality of life, hypoestrogenism-associated symptoms, and bone mineral density.
Bone Density
;
Cohort Studies
;
Endometriosis*
;
Estradiol
;
Female
;
Gonadotropin-Releasing Hormone*
;
Humans
;
Incidence
;
Laparoscopy
;
Norethindrone
;
Prospective Studies
;
Quality of Life
;
Spine
7.Efficacy of Post-Operative Medication to Prevent Recurrence of Endometrioma: Cyclic Oral Contraceptive (OC) After Gonadotropin-Releasing Hormone (GnRH) Agonist Versus Dienogest
Seung-Hye CHOI ; Sung Eun KIM ; Hyun Hye LIM ; Dong-Yun LEE ; DooSeok CHOI
Journal of Korean Medical Science 2022;37(26):e207-
Background:
There are several medical treatment options for endometrioma. Progestin, especially dienogest, is an effective drug for preventing recurrence of endometrioma after surgery. Additionally, oral contraceptive (OC) use after conservative surgery has been reported to reduce significantly the risk of endometrioma recurrence. The aim of this study was to compare the long-term effects of gonadotropin-releasing hormone (GnRH) agonist followed by OC to those of dienogest alone to prevent recurrence of endometrioma after laparoscopic surgery.
Methods:
A retrospective cohort study was performed on patients who underwent conservative laparoscopic surgery for endometrioma between January 2000 and December 2020, in the Endometriosis Clinic, Department of Gynecology, Samsung Medical Center. A total of 624 patients who received medical treatment at least six months after laparoscopic conservative surgery for endometrioma was included. Among them, 372 patients used OC after GnRH agonist therapy, and 252 patients used dienogest. Within the OC group, 148 used a 21/7 regiment and 224 used a 24/4 regimen. A cumulative endometrioma recurrence curve was presented using the Kaplan-Meier method to compare the recurrence of those groups.
Results:
The cumulative recurrence rate of endometrioma for 60 months was 2.08% (n = 4) in the OC after GnRH agonist group and 0.40% (n = 1) in the dienogest group. There was no statistical difference in cumulative recurrence of endometrioma between the two groups. In subgroup analysis, the cumulative recurrence rate of endometrioma over 60 months was 4.21% (n = 2) in the 21/7 OC group and 1.09% (n = 2) in the 24/4 OC group and showed no significant difference.
Conclusion
Long-term use of OC after GnRH agonist as well as that of dienogest treatment are effective postoperative medical therapies for preventing endometrioma recurrence. Thus, the choice of regimen can be individualized or used interchangeably depending on patient condition, need for contraception, and compliance with drug therapy.
8.A FRAX Experience in Korea: Fracture Risk Probabilities with a Country-specific Versus a Surrogate Model.
Yong Ki MIN ; Dong Yun LEE ; Youn Soo PARK ; Young Wan MOON ; Seung Jae LIM ; Young Kyun LEE ; DooSeok CHOI ; Byung Koo YOON
Journal of Bone Metabolism 2015;22(3):113-118
BACKGROUND: Recently, a Korean fracture-risk assessment tool (FRAX) model has become available, but large prospective cohort studies, which are needed to validate the model, are still lacking, and there has been little effort to evaluate its usefulness. This study evaluated the clinical usefulness of the FRAX model, a FRAX developed by the World Health Organization, in Korea. METHODS: In 405 postmenopausal women and 139 men with a proximal femoral fracture, 10-year predicted fracture probabilities calculated by the Korean FRAX model (a country-specific model) were compared with the probabilities calculated with a FRAX model for Japan, which has a similar ethnic background (surrogate model). RESULTS: The 10-year probabilities of major osteoporotic and hip fractures calculated by the Korean model were significantly lower than those calculated by the Japanese model in women and men. The fracture probabilities calculated by each model increased significantly with age in both sexes. In patients aged 70 or older, however, there was a significant difference between the two models. In addition, the Korean model led to lower probabilities for major osteoporotic fracture and hip fracture in women when BMD was excluded from the model than when it was included. CONCLUSIONS: The 10-year fracture probabilities calculated with FRAX models might differ between country-specific and surrogate models, and caution is needed when applying a surrogate model to a new population. A large prospective study is warranted to validate the country-specific Korean model in the general population.
Asian Continental Ancestry Group
;
Cohort Studies
;
Female
;
Femoral Fractures
;
Hip
;
Hip Fractures
;
Humans
;
Japan
;
Korea*
;
Male
;
Osteoporotic Fractures
;
Prospective Studies
;
Republic of Korea
;
Risk Assessment
;
World Health Organization
9.Effect of Transdermal Estrogen Therapy on Bone Mineral Density in Postmenopausal Korean Women.
Hyo Jeong KIM ; Yoon Kyung OH ; Ji Soo LEE ; Dong Yun LEE ; DooSeok CHOI ; Byung Koo YOON
Journal of Menopausal Medicine 2014;20(3):111-117
OBJECTIVES: To evaluate the effects of transdermal estrogen therapy on bone mineral density (BMD) in postmenopausal Korean women. METHODS: A total of 149 healthy postmenopausal women were retrospectively evaluated: 100 were on hormone therapy (HT) and 49 were the control group. For the HT group, 54 applied estrogen transdermally using either a patch (n = 21) or gel (n = 33), and 46 took estrogen orally (conjugated estrogen 0.625 mg or equivalent). Demographic profiles and changes in BMD over two years were compared according to the route of the estrogen. RESULTS: No differences were found in age, age at menopause, parity, body mass index, and type of menopause among the oral, transdermal and control groups. Compared with controls, HT significantly increased BMD after 2 years in both the lumbar spine and the total hip. The increases in BMD at both lumbar spine and hip were comparable between the oral and transdermal groups. There were also no differences in BMD changes according to progestogen addition in either the oral or transdermal groups. CONCLUSION: Transdermal estrogen therapy increases BMD, comparable to oral estrogen, in postmenopausal Korean women.
Body Mass Index
;
Bone Density*
;
Estrogens*
;
Female
;
Hip
;
Hormone Replacement Therapy
;
Humans
;
Menopause
;
Parity
;
Postmenopause
;
Retrospective Studies
;
Spine
10.Impact of Lysophosphatidylcholine on the Plasminogen Activator System in Cultured Vascular Smooth Muscle Cells.
Byung Koo YOON ; Young Hee KANG ; Won Jong OH ; Kyungwon PARK ; Dong Yun LEE ; Dooseok CHOI ; Duk Kyung KIM ; Youngjoo LEE ; Mee Ra RHYU
Journal of Korean Medical Science 2012;27(7):803-810
The balance between tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) regulates fibrinolysis. PAI-1 expression increases in atherosclerotic arteries and vascular smooth muscle cells (VSMCs) are one of major constituents of atheroma. We investigated the impact of lysophosphatidylcholine (lysoPC), an active component of oxidized low-density lipoprotein, on the plasminogen activator system of the rat VSMCs. The lysoPC stimulated the protein and gene expressions of PAI-1 but did not affect the protein expression of t-PA. Fibrin overlay zymography revealed that lysoPC increased the activity of PAI-1 in the conditioned media, while concurrently decreasing that of free t-PA. Vitamin E inhibited the lysoPC-induced PAI-1 expression. Further, lysoPC increased the intracellular reactive oxygen species (ROS) formation. Caffeic acid phenethyl ester, an inhibitor of NF-kappaB, blocked this lysoPC effect. Indeed, lysoPC induced the NF-kappaB-mediated transcriptional activity as measured by luciferase reporter assay. In addition, genistein, an inhibitor of protein-tyrosine kinase (PTK), diminished the lysoPC effect, while 7,12-dimethylbenz[a]anthracene, a stimulator of PTK, stimulated PAI-1 production. In conclusion, lysoPC does not affect t-PA expression but induces PAI-1 expression in the VSMC by mediating NF-kappaB and the genistein-sensitive PTK signaling pathways via oxidative stress. Importantly, lysoPC stimulates the enzyme activity of PAI-1 and suppresses that of t-PA.
Animals
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Benz(a)Anthracenes/pharmacology
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Caffeic Acids/pharmacology
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Cells, Cultured
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Genistein/pharmacology
;
Lipoproteins, LDL/metabolism
;
Lysophosphatidylcholines/*pharmacology
;
Muscle, Smooth, Vascular/cytology/*drug effects/metabolism
;
NF-kappa B/antagonists & inhibitors/metabolism
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Oxidative Stress/drug effects
;
Phenylethyl Alcohol/analogs & derivatives/pharmacology
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Plasminogen Activator Inhibitor 1/agonists/genetics/*metabolism
;
Protein Kinase Inhibitors/pharmacology
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Protein-Tyrosine Kinases/antagonists & inhibitors/metabolism
;
Rats
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Rats, Sprague-Dawley
;
Reactive Oxygen Species/metabolism
;
Signal Transduction/drug effects
;
Tissue Plasminogen Activator/*metabolism
;
Transcription, Genetic/drug effects
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Up-Regulation/drug effects
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Vitamin E/pharmacology