OBJECTIVES: The purpose of this study was to examine the relationship between serum ferritin and metabolic syndrome in peri- and postmenopausal women. METHODS: The study subjects consisted of 2,091 peri- and postmenopausal women who visited the hospital for a health check-up in 2007. They were divided into the metabolic syndrome group (MetS) and the non-metabolic syndrome group (Non-MetS). RESULTS: Mean serum ferritin values were 65.16 +/- 33.69 ng/mL in MetS and 57.82 +/- 32.51 ng/mL in Non-MetS (P = 0.000). In MetS, serum ferritin had a positive correlation with hemoglobin (Hb), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, aspartate transaminase (SGOT), alanine transaminase (SGPT), uric acid, and high-sensitivity C-reactive protein (hs-CRP) but a negative correlation with high-density lipoprotein (HDL)-cholesterol and low-density lipoprotein (LDL)-cholesterol (P < 0.05). From multiple linear models, hs-CRP, HDL-cholesterol, SGOT, HOMA-IR, and hemoglobin level were found to be the best predictors of serum ferritin in MetS (R 2 = 0.106; P < 0.05). CONCLUSION: The serum ferritin level in MetS was higher than in Non-MetS in postmenopausal women. In MetS, with increasing hs-CRP, SGOT, HOMA-IR, and hemoglobin levels and decreasing HDL-cholesterol levels, the serum ferritin level seems to increase
Alanine Transaminase ; Aspartate Aminotransferases ; Atherosclerosis ; C-Reactive Protein ; Cardiovascular Diseases ; Female ; Ferritins ; Hemoglobins ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Linear Models ; Lipoproteins ; Postmenopause ; Uric Acid

OBJECTIVES: Premature ovarian failure (POF) is a syndrome defined as the cessation of ovarian function before the age of 40 years that is characterized by amenorrhoea associated with elevated gonadotropin levels. The aim of this study was to compare clinical manifestation of primary amenorrhea and secondary amenorrhea group. METHODS: This study was designed as a retrospective multicenter study of 262 women with premature ovarian failure. Sixty eight women with primary amenorrhea and 194 women with secondary amenorrhea were evaluated and hormonal level, lipid profile, bone mineral density, and pregnancy rates were compared. RESULTS: The estradiol level was markedly lower in primary amenorrhea than secondary amenorrhea. The pregnancy rate of 43.3% before the diagnosis in secondary amenorrhea was markedly higher than the rate of 0% in primary amenorrhea. The pregnancy rates after treatment was 5.9% in primary amenorrhea, but 1.0% after diagnosis and 2.8% after treatment in secondary amenorrhea. The pregnancy rate after hormonal treatment was 3.7% in total, 8.3% in primary amenorrhea, and 2.8% in secondary amenorrhea. In nine cases of pregnancy, seven cases were after estrogen-progestin (EP), one case was after clomiphene citrate and one case was after EP/human menopausal gonodotropin (hMG). And In nine cases of pregnancy, six cases resulted from oocyte donation. The prevalence of osteopenia/osteoporosis was markedly higher in primary amenorrhea than in secondary amenorrhea. CONCLUSION: Premature ovarian failure has negative influences on the physical and psychological health of young patients. Effective management should include earlier diagnosis and intensive medical intervention to relieve symptoms of estrogen deficiency and to treat long-term disease such as osteoporosis and in assisted pregnancy by oocyte donation.
Amenorrhea ; Bone Density ; Clomiphene ; Estradiol ; Estrogens ; Female ; Gonadotropins ; Humans ; Oocyte Donation ; Osteoporosis ; Pregnancy ; Pregnancy Rate ; Prevalence ; Primary Ovarian Insufficiency ; Retrospective Studies

OBJECTIVES: To investigate the prevalence of human papillomavirus (HPV) infection in Bucheon province. METHODS: Two hundred eighty Korean women (average age 41.9, range 21~90 years) were enrolled, who received a regular thinprep pap test and an HPV deoxyribonucleic acid (DNA) chip test simultaneously at Soonchunhyang University Hospital, Bucheon, from February 2011 to March 2011. RESULTS: The overall prevalence of HPV infection was 33.9% (95/280). The prevalence of HPV infection in postmenopausal women (24.3%) was significantly lower than that of premenopausal women (37.1%, P = 0.049). CONCLUSION: Although the prevalence of HPV infection in postmenopausal women was lower than that of premenopausal women, HPV infection is more critical in postmenopausal women as HPV infection in postmenopausal women is more likely to induce cervical cancer than in premenopausal women.
DNA ; Female ; Humans ; Menopause ; Papilloma ; Perimenopause ; Prevalence ; Uterine Cervical Neoplasms ; Viruses

OBJECTIVES: To analyze the domestic consumption of postmenopausal hormonal medicine in the year 2010 and compare it with those since 2002. METHODS: Data from Intercontinental Marketing Services were used to analyze the consumption of hormonal medicine in the year 2010. Total hormonal medicines consisted of estrogen (ET), estrogen+progestogen (EPT), and Tibolone. We compared the respective consumption of hormonal medicines in the year 2010 with those since 2002. The percentage and frequency of usage of ET, ET/EPT, and tibolone in the year 2010 were also estimated. RESULTS: We found that 4.5% of women over 50 years of age had taken the postmenopausal hormonal medicine in the year 2010. The usage rate of each medicine showed 60% for ET/EPT compound, and 40% for Tibolone. The usage of postmenopausal hormonal medicine in 2010 increased by 7% compared to the previous year reaching 3.81 billion Korean won. There was 9% increase in the use of ET/EPT compound, and 4% increase in Tibolone. CONCLUSION: The total consumption of postmenopausal hormonal medicine was markedly decreased between 2002 and 2007. Since 2007, however, it has been steadily increasing from 3.01 billion to more than 3.81 billion Korea won in 2010, which maybe due to the reappraisal of the WHI study results, the change of doctor's recognition, and the increased consumption of Tibolone. When initiating postmenopausal hormone replacement therapy, the risk-benefit of hormonal therapy should be thoroughly explored.
Estrogen Replacement Therapy ; Estrogens ; Female ; Humans ; Korea ; Marketing ; Norpregnenes ; Postmenopause

OBJECTIVES: After Women's Health Initiative (WHI) study had been published, the use of hormone therapy (HT) have been decreasing even though it is the most effective therapy for menopausal symptom. The survey was conducted to investigate Korean menopausal women's perception of HT and behavior when they are treated by HT. METHODS: During 4 weeks from September 2009 to October 2009, total 600 women aged 45~64 participated in the survey by face to face interview. Out of answering women, women who have visited clinic/hospital at least 1 time to treat their menopausal symptom during last 1 year were included. One hundred fifty women for each age group, 45~49, 50~54, 55~59 and 60~64, were recruited in consecutive order. RESULTS: Eighty percent women who have visited clinic/hospital to treat menopausal symptom, visited obstetrics and gynecology. Only 16% of these women were current user, and other 84% of these women had no experience of HT (53%) or stopped therapy (31%). Among current user, only 9% of women have used HT more than 5 years. Eighty percent of current user had used HT less than 2 years. Most distressing menopausal symptom is 'hot flush' regardless HT experience. When doctor recommend HT, 72% of patients accept HT in overall. Among women who had no experience of HT, the most common reason of not to take HT was concern of side effects (51%). And 67% of women who had concern of side effects worried about cancer incidence. CONCLUSION: Many women with menopausal symptom do not take HT even though it is the most effective therapy. Most of women who take HT stop treatment within 1 year. Most common reason of not to take HT is concern about side effect, increasing incidence of cancer related to HT. Therefore, HT should be considered to short-term relief of menopausal symptoms and at the minimal dose, if possible.
Aged ; Female ; Gynecology ; Humans ; Incidence ; Menopause ; Obstetrics ; Women's Health

Because sex hormones influence the lower urinary tract, menopause can cause several urinary diseases including overactive bladder, stress urinary incontinence and recurrent urinary tract infection. However, the results of many clinical studies have indicated that menopausal hormone replacement therapy is not effective for the treatment of previous diseases, especially via the oral route. Although estrogen vaginal cream or pessary is an effective treatment for overactive bladders and can prevent recurrent urinary tract infection, its beneficial effects only last for the duration of the treatment. If patients with previous mentioned urologic disease have other local symptoms and conditions, such as atrophic vaginitis and dyspareunia, local estrogen replacement therapy will be helpful in relieving the local symptoms. However, the potential for breast cancer or return of withdrawal of bleeding, patient's age, adverse effect of systemic administration, estrogen-progesterone combination therapy, and effectiveness among other treatment modalities must be considered before a treatment decision can be made. In this article, we will review the current issues on the relationship among urinary tract and sex hormone and menopause, and the effectiveness of menopausal hormone replacement therapy for the treatment of overactive bladders, stress urinary tract incontinence and recurrent urinary tract infection.
Atrophic Vaginitis ; Breast Neoplasms ; Dyspareunia ; Estrogen Replacement Therapy ; Estrogens ; Female ; Gonadal Steroid Hormones ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Menopause ; Pessaries ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Urologic Diseases ; Vaginal Creams, Foams, and Jellies

Metabolic syndrome (MS) in women, which is characterized with central obesity, insulin resistance, and dyslipidemia, is associated with high risk of cardiovascular disease (CVD) and diabetes. Menopause may be related with the prevalence of MS and increased CVD risk through effects on central obesity, lipid metabolism, and prothrombotic state. The emergence of these risk factors may be a direct result from the failure of estrogen production. Alternatively, metabolic changes with estrogen deficiency may be the indirect cause of those risks. Additionally, most women may have a few chances of developing MS during their life, such as pregnancy-related weight gain, hormonal contraceptive use and polycystic ovary syndrome. Therefore, it is difficult to conclude that menopause itself can be the cause of MS. Representative managements of MS are life style modification and use of lipid lowering medication. This article will review the relationship between the development of MS and menopause. A better understanding on the metabolic changes with menopause will help identify women with risk factors of CVD and provide appropriate interventions
Cardiovascular Diseases ; Dyslipidemias ; Estrogens ; Female ; Humans ; Insulin Resistance ; Life Style ; Lipid Metabolism ; Menopause ; Metabolic Syndrome X ; Obesity, Abdominal ; Polycystic Ovary Syndrome ; Prevalence ; Risk Factors ; Weight Gain

OBJECTIVES: To assess the effects of hormone replacement therapy on bone mineral density (BMD), biochemical markers of bone turnover, and lipid profiles in postmenopausal women. METHODS: We retrospectively reviewed the medical records of 199 postmenopausal women who had received care at the Department of Obstetrics and Gynecology of Catholic University Seoul St. Mary's Hospital between January 1994 and December 2008. The patients were divided into the following three groups: group 1 received combined estrogen and progesterone therapy (n = 91); group 2 received estrogen only (n = 65); and group 3 received tibolone (n = 43). We compared the changes in biochemical markers of bone turnover, lipid profiles, and BMD during therapy. RESULTS: The BMD of the lumbar spine increased in groups 1 and 3 by 2.0% and 1.2%, respectively, and the BMD of the total femur increased in groups 1 and 2 by 2.3% and 0.5% from the initial values after 3 years, respectively. However, the BMD of the femoral neck and total femur decreased significantly in group 3 by 4.8% and 1.9%, respectively, 3 years after treatment initiation (P < 0.05). Serum osteocalcin and urinary deoxypyridinoline decreased in all groups 1 year after treatment. In groups 1 and 3, the total cholesterol level decreased and the triglycerides level increased. However, there were no definite changes in the total cholesterol and triglycerides levels in group 2. The high density lipoprotein cholesterol (HDL)-cholesterol level increased in groups 1 and 2, but decreased in group 3. As a result, the BMD of the lumbar spine increased and the total cholesterol level decreased in the combined therapy and tibolone groups. Tibolone had no beneficial effect on the BMD of the femoral neck. CONCLUSION: Our results suggest that each therapy has different effects on BMD, biochemical markers of bone metabolism, and lipid profiles. A prospective study involving a larger group, and considering multiple factors, will be required to obtain more clinically meaningful conclusions.
Amino Acids ; Biomarkers ; Bone Density ; Cholesterol ; Cholesterol, HDL ; Estrogens ; Female ; Femur ; Femur Neck ; Gynecology ; Hormone Replacement Therapy ; Humans ; Lipoproteins ; Medical Records ; Norpregnenes ; Obstetrics ; Osteocalcin ; Progesterone ; Retrospective Studies ; Spine ; Triglycerides

OBJECTIVES: To investigate the safety and effect of pomegranate extract on postmenopausal syndrome. METHODS: One hundred twelve women participated in a randomized, double-blind, placebo-controlled trial conducted in a tertiary university hospital in Korea. Women were treated with pomegranate extract or placebo for 12 weeks. The primary end point was menopausal symptoms, which were evaluated based on the Kupperman Index. The secondary end point was the serum estradiol (E2, pg/ml) level. Statistical analysis was performed. RESULTS: Menopausal symptoms as the Kupperman Index were significantly improved in the pomegranate group compared to placebo during the 12 weeks of intervention (P < 0.0001). Melancholia did not differ between the two groups. There was also no difference in serum E2 levels. There were no differences between the two groups in age, body weight, height, systolic and diastolic blood pressures, serum white and red blood cell counts, and fasting blood glucose, hemoglobin, aspartic transaminase, alanine transaminase, total cholesterol, triglycerides, high- and low-density lipoprotein-cholesterol, creatinine, and E2 levels. The side effects of pomegranate extract were negligible. CONCLUSION: Pomegranate extract is safe and effective in the treatment of menopausal symptoms. Further studies on whether or not the beneficial effect of pomegranate extract is due to the estrogen component are needed.
Alanine Transaminase ; Blood Glucose ; Body Weight ; Cholesterol ; Creatinine ; Depressive Disorder ; Erythrocyte Count ; Estradiol ; Estrogens ; Fasting ; Female ; Hemoglobins ; Humans ; Korea ; Punicaceae ; Triglycerides

OBJECTIVES: Insulin resistance plays an important role in cardiovascular diseases, type 2 diabetes, and non-alcoholic fatty liver disease. The objective of this study was to determine the association between obesity and elevated alanine aminotransferase (ALT) with insulin resistance and compare these factors with metabolic syndrome in postmenopausal women. METHODS: We analyzed 606 postmenopausal women who had visited the Health Promotion Center. The medical history and lifestyle data were collected by questionnaire and history taking. Anthropometric parameters and blood pressure were measured. Laboratory tests included fasting glucose and insulin levels, and liver and lipid profiles. Metabolic syndrome was defined based on NCEP-ATP III criteria. As a maker of insulin resistance, the homeostatic model assessment-insulin resistance (HOMA-IR) was calculated. We grouped all subjects into four groups, based on the quartiles of HOMA-IR. The top fourth quartile group was defined as the group with insulin resistance. We performed multivariate logistic regression analysis for the odds ratio of the risk for insulin resistance. RESULTS: The prevalence rates of obesity (body mass index > or = 25 kg/m2) and elevated ALT (> or = 34 U/L) increased with increased HOMA-IR. Obesity and elevated ALT were associated with insulin resistance, after adjusting for age, smoking status, and exercise. Women with co-existing obesity and elevated ALT were at increased risk for insulin resistance (OR = 5.87; 95% CI, 2.93~11.74) compared to women with metabolic syndrome (OR = 3.43; 95% CI, 2.18~5.41). CONCLUSION: Obesity and elevated ALT are associated with insulin resistance in postmenopausal women. A combination of these factors is superior to metabolic syndrome in predicting insulin resistance.
Alanine Transaminase ; Blood Pressure ; Cardiovascular Diseases ; Fasting ; Fatty Liver ; Female ; Glucose ; Health Promotion ; Humans ; Insulin ; Insulin Resistance ; Life Style ; Liver ; Logistic Models ; Menopause ; Obesity ; Odds Ratio ; Prevalence ; Smoke ; Smoking ; Surveys and Questionnaires