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: The aim of the present study was to investigate the influence of levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena(R)) on the mammographic density, mammographic findings and breast ultrasonographic findings in Korean premenopausal women. METHODS: We reviewed medical records of 639 premenopausal women, who inserted LNG-IUS in our department from 2000-2011. Among these, 46 women, who underwent regular mammography (MMG) or breast ultrasonography (USG) examination in radiology department before and after insertion of the LNG-IUS after establishment of picture archiving and communication system (PACS) system in our hospital were finally included in this analysis. We compared the findings of MMG and breast USG between pre- and post-insertion of LNG-IUS. We also checked the pathologic results of any breast biopsy performed in these study participants. The Cochran-Armitage trend test was used to investigate the changes pre- and post-insertion of LNG-IUS. RESULTS: The mean age of participants was 42.3 +/- 4.9 years and the mean interval period for MMG and US follow-up (FU) was 25.5 +/- 10.8 months and 25.2 +/- 11.5 months, respectively. The density of MMG before insertion of LNG-IUS correlated well with the FU MMG density. The findings of MMG and US also correlated well before and after insertion of LNG-IUS. There was no case of breast cancer among women who were supposed to undergo breast biopsy because of abnormal findings in MMG and US. CONCLUSION: The use of LNG-IUS did not cause any changes in MMG density, findings of MMG, and findings of breast USG in healthy premenopausal Korean women.
Biopsy ; Breast ; Breast Neoplasms ; Female ; Follow-Up Studies ; Humans ; Levonorgestrel ; Mammary Glands, Human ; Mammography ; Medical Records ; Ultrasonography, Mammary

OBJECTIVES: The aim of this study is to estimate the relative risk for breast cancer using the Gail model and to observe the relationship between mammographic density and the 5-year risk of breast cancer. METHODS: A total of 600 women who visited the Department of Obstetrics and Gynecology in Chung-Ang University Yongsan Hospital were screened using the Gail model to estimate their relative risk for breast cancer. The correlation between the 5-year risk of breast cancer and the mammographic density of 462 women who had performed mammography within 1 year of the study was analyzed. RESULTS: The mean age of the study subjects was 56.7 +/- 8.2 years. The estimated mean values for the 5-year risk and lifetime risk for breast cancer were 1.23 +/- 0.46% and 7.90 +/- 2.76% respectively in all study subjects. The estimated mean value of the 5-year risk for breast cancer increased with age. Otherwise, the estimated lifetime risk for breast cancer decreased with age. Ninety-two women (15.3%) were classified as high-risk because their estimated 5-year risk was over 1.67% or their lifetime risk was over 20%. High risk percentages according to age were 10.5% in the thirties, 0.84% in the forties, 7.2% in the fifties, 32.7% in the sixties, and 35.7% in the seventies. Among the high risk postmenopausal women, 52.2% were taking hormone therapy. Mammographic density was not significantly correlated with the estimated 5-year risk for breast cancer. CONCLUSION: About fifteen percent of study subjects were at high risk for breast cancer according to the estimated 5-year risk or lifetime risk for breast cancer using Gail model. Mammographic density was not correlated with the 5-year risk for breast cancer.
Breast ; Breast Neoplasms ; Female ; Gynecology ; Humans ; Mammary Glands, Human ; Mammography ; Obstetrics ; Risk Assessment

OBJECTIVES: Hormone therapy is generally chosen to treat women who are experiencing menopausal symptoms. Knowing the overlapping symptoms between menopause and thyroid diseases as well as their increasing trend, it is crucial to differentially diagnose among the two types of diseases. The study is focused on the thyroid function test (TFT) and its significance. It also reflects those who are in the menopausal transition state, suffering from premenopausal symptoms, and therefore, want to be treated with hormone therapy. METHODS: Endocrinologic diagnosis for menopause was performed in 139 patients who complained of menopausal symptoms and irregular menstruation within the past year and hence, visited the Department of Obstetrics and Gynecology, Kyung Hee University Hospital in order to obtain consultation from January 2007 to March 2011. We made observations using the retrograde method. Among these women, 43 patients tested for TFT for their atypical menopausal symptoms. RESULTS: Among the 43 patients who tested for TFT, 10 patients showed abnormal TFT and 3 patients who did not take TFT at our department were found to have the thyroid disease later by other clinics. CONCLUSION: In order to differentiate thyroid disease, practical guidelines should be prepared for the management of women with menopausal transition.
Female ; Gynecology ; Humans ; Menopause ; Menstruation ; Obstetrics ; Perimenopause ; Stress, Psychological ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland