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GnRH Agonist Co-treatment for Prevention of Primary Ovarian Insufficiency in Patients with Hematologic Malignancies Undergoing Chemotherapy.

Sungwook CHUN ; Yong Il JI ; Young Don JOO

The Journal of Korean Society of Menopause.2013;19(2):93-100. doi:10.6118/jksm.2013.19.2.93

OBJECTIVES: The aim of this study was to assess the effect of gonadotropin-releasing hormone (GnRH) agonist co-treatment for gonadal protection in patients with hematologic neoplasms undergoing chemotherapy. METHODS: Young premenopausal women who were diagnosed with leukemia or lymphoma between March 2010 and February 2012 and undergoing chemotherapy in a university hospital were included in this study. RESULTS: Twenty-nine patients aged 15.39 years participated in this study. Among the patients, five patients were receiving leuprolide concomitant with chemotherapy, and twenty-four patients were receiving chemotherapy alone. Seventeen patients in the chemotherapy alone group stopped menstrating and were diagnosed with primary ovarian insufficiency (POI) within one year after chemotherapy; and only one patient had POI in the chemotherapy plus leuprolide group, but these differences were not statistically significant (P = 0.054). In the chemotherapy plus leuprolide group, serum anti-mullerian hormone (AMH) levels were significantly lower than basal serum AMH levels (5.57 +/- 0.18 ng/mL) (P < 0.001) after treatment (1.84 +/- 0.22 ng/mL). CONCLUSION: GnRH agonist may be a promising option for the prevention of POF, but the effectiveness of GnRH agonist is still debatable. A large prospective multi-center trial with adequate follow-up is needed.
Aged ; Anti-Mullerian Hormone ; Female ; Gonadotropin-Releasing Hormone ; Gonads ; Hematologic Neoplasms ; Humans ; Leukemia ; Leuprolide ; Lymphoma ; Primary Ovarian Insufficiency

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A Clinical Analysis of Patients with Premature Ovarian Failure: Compliance with Hormonal Treatment.

Hee Suk LEE ; Ji Hoon OK ; Joo Myung KIM ; Yeon Jean CHO

The Journal of Korean Society of Menopause.2013;19(2):87-92. doi:10.6118/jksm.2013.19.2.87

OBJECTIVES: To analyze the clinical features of premature ovarian failure (POF) and patients' compliance with hormonal treatment. METHODS: A retrospective analysis of 126 patients diagnosed with POF was selected between January 2004 and December 2007. The clinical, etiologic features and treatment compliance were evaluated. RESULTS: The mean age of diagnosis was 33.2 +/- 5.2 years. The mean value of follicle stimulating hormone was 78.8 +/- 28.8 IU/L. The most common symptom was amenorrhea or oligomenorrhea (54%). Eighty-eight patients were married and 22 of them visited our clinic due to infertility. The most common etiology was unknown (54.8%) and the second most common cause was iatrogenic (29.4%). Only 61 patients underwent hormonal treatment (48.4%). The remaining 11 patients did not undergo hormonal treatment due to other medical conditions such as breast cancer or liver disease; however, they were followed-up regularly (8.7%). Among the treatment group, only 37 patients were followed-up over a period of 12 months (60.7%). CONCLUSION: About half of the women diagnosed with POF did not accept their own problems and therefore delayed essential treatment. Clinicians should educate the importance of early treatment for preventing degenerative changes.
Amenorrhea ; Breast Neoplasms ; Compliance ; Female ; Follicle Stimulating Hormone ; Humans ; Infertility ; Liver ; Oligomenorrhea ; Primary Ovarian Insufficiency ; Retrospective Studies

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Association between Serum Homocysteine Concentrations and Bone Mineral Density in Middle Aged Women.

Ari KIM ; Jun Hee LEE ; Ji Young LEE ; Young Min OH ; Sung Nam HONG ; Hoon CHOI ; Eun Ae JAE ; Hae Hyeog LEE ; Heung Yeol KIM

The Journal of Korean Society of Menopause.2013;19(2):81-86. doi:10.6118/jksm.2013.19.2.81

OBJECTIVES: Hyperhomocysteinemia is known to be related with the early onset of osteoporosis. This study was to examine the association between serem homocysteine levels and bone mineral density (BMD) in middle aged women. METHODS: The study included 409 women who underwent bone density tests in the health screening centers from January 2009 to october 2010. Serum homocysteine levels and BMD were measured. RESULTS: Postmenopause group (n = 109) showed significantly lower BMD score in lumbar spine and femoral neck and significantly higher serum homocysteine concentration compared to premenopause group (n = 300). However, after adjusting for age, body mass index, and the menopausal condition in total 409 women, there were no significant correlations between serum homocysteine levels and BMD. CONCLUSION: Measurement of serum homocysteine levels may not be useful, but adjunctive for the risk assessment of osteoporosis in middle aged women.
Body Mass Index ; Bone Density ; Female ; Femur Neck ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Mass Screening ; Middle Aged ; Osteoporosis ; Postmenopause ; Premenopause ; Risk Assessment ; Spine

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Risk Factors Associated with Premalignant and Malignant Endometrial Polyps.

Hee Suk LEE ; Yeon Jean CHO ; Joo Myung KIM

The Journal of Korean Society of Menopause.2013;19(2):74-80. doi:10.6118/jksm.2013.19.2.74

OBJECTIVES: The objective of this study is to evaluate the prevalence of endometrial premalignant and malignant polyps in women who underwent hysteroscopic polypectomies, and to investigate whether clinical parameters predict histopathologic outcomes. METHODS: A review was carried out on the medical records of patients who had undergone hysteroscopic endometrial polypectomy from January 2010 to December 2011. One thousand one hundred ninety-six women who ranged in age from 16 to 81 years were included in the study. Polyps were classified as benign (endometrial polyps and polyps with non-atypical simple hyperplasia and non-atypical complex hyperplasia), premalignant (polyps with atypical simple hyperplasia or atypical complex hyperplasia), or malignant. A statistical analysis was then performed. RESULTS: Histopathologically, 96.7% benign, 1.1% premalignant, and 2.2% malignant lesions were detected. Abnormal uterine bleeding and postmenopause were the only factors which were determined to be associated with a higher risk of malignancy, with an odds ratios of 5.07 (95% CI, 2.25-11.41) and 3.41 (95% CI, 1.14-10.24), respectively. CONCLUSION: The risk factors associated with premalignant and malignant endometrial polyps include abnormal uterine bleeding and menopause.
Endometrial Neoplasms ; Female ; Humans ; Hyperplasia ; Hysteroscopy ; Medical Records ; Menopause ; Metrorrhagia ; Odds Ratio ; Polyps ; Postmenopause ; Prevalence ; Risk Factors ; Uterine Hemorrhage

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Associations between Estrogen Receptor Gene Polymorphisms and Endometriosis.

Myung Jin MUN ; Jin Ho KIM ; Tae Hee KIM ; Ji Young HWANG ; Won Choeul JANG

The Journal of Korean Society of Menopause.2013;19(2):64-73. doi:10.6118/jksm.2013.19.2.64

Endometriosis is common estrogen-related gynecological diseases related to interactions of dietary, genetic causes, social and environmental factors. The high prevalence approaches 5-15% in premenopausal women and 30% in infertile women, and it is unusual to occur after the onset of menopause. In this review, the gene polymorphisms of estrogen receptor (ER) alpha and betare-lated to the risks of endometriosis were investigated through statistical analysis by using the gene polymorphism for the risks of the disease examined trends. The polymorphism of ERalpha-PvuII in Europe tends to increase the risk of endometriosis and, ERalpha-XbaI polymorphisms in both Asia and Europe have a slightly increased risk of endometriosis. In the case of ERbeta-RsaI, the risk of endometriosis increases in Brazil, while the polymorphism of ERbeta-AluI reduces the disease risks in Asia. Polymorphism studies on ER associated with the risk of endometriosis in Asia and Europe showed that those polymorphisms may be used to predict the high or low risks of endometriosis, and potentially used for prevention, therapy or prognosis of endometriosis. Further studies on interacting with more related genes and environmental factors may provide a better understanding of associations between estrogen receptor gene polymorphisms and endometriosis.
Asia ; Brazil ; Endometriosis ; Estrogens ; Europe ; Female ; Humans ; Menopause ; Prevalence ; Prognosis

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The Relationship of Hot Flush to Other Menopausal Symptoms and Chronic Disease Related to Menopause.

Sungwook CHUN

The Journal of Korean Society of Menopause.2013;19(2):54-63. doi:10.6118/jksm.2013.19.2.54

Hot flush is one of the most commonly reported symptoms during menopause and it is referred to as vasomotor symptoms along with night sweats. I have summarized the current available knowledge on the relationships between hot flush to other menopausal symptoms and the related chronic diseases to menopause in this article.
Chronic Disease ; Female ; Menopause ; Sweat

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Health Care for Transwoman (Male to Female).

Tae Hee KIM ; Hae Hyeog LEE ; Wonsil MOON

The Journal of Korean Society of Menopause.2013;19(2):45-53. doi:10.6118/jksm.2013.19.2.45

Gender is determined at fertilization. However, gender mentally decision is another issue. Transgender is a familiar word in general populations, but the definition of transgender and exact managements are not familiar to physicians including gynecologists. Transgender is not well received for health care benefits, because primary care about the transgender is not known to the physicians. Transgender is hidden in the social health care system, Transgender individuals wish to be assisted to feminize or masculinize their bodies including gestures, facial expression etc. Primary health care for transgender diversely includes psychological, medical, and surgical treatments. Basic management of transgender is hormonal therapy, thus we should guide the management for appropriate hormone therapies. Our review article provides guidelines for the gynecologist to assist and to help the transgender for primary care.
Delivery of Health Care ; Facial Expression ; Fertilization ; Gestures ; Humans ; Primary Health Care ; Transgender Persons ; Transsexualism

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Non-vertebral Fractures due to Recurrent Falls after Premature Menopause.

Tae Hee KIM ; Hae Hyeog LEE ; Soo Ho CHUNG ; Yun Jung YANG

The Journal of Korean Society of Menopause.2010;16(1):52-54.

Premature menopause is due to ovarian dysfunction. Premature menopause is characterized by arrested folliculogenesis before 40 years of age. Premature menopause is associated with health problems. The impact of estrogen deficiency tends to be chronic problems rather than acute. We have managed a case of recurrent non-vertebral fractures due to falls after premature ovarian dysfunction. We present this case with a brief review of the literature.
Estrogens ; Female ; Menopause, Premature

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Clinical Applications of Hysteroscopic Surgery in Postmenopausal Women.

Kina UY ; Tae Hee KIM ; Hae Hyeog LEE ; Soo Ho CHUNG ; Byoung Ick LEE

The Journal of Korean Society of Menopause.2010;16(1):46-51.

OBJECTIVES: To evaluate the spectrum of hysteroscopic surgery to be extended. METHODS: Forty-three women who underwent hysteroscopic procedures with Urione(R) solution or normal saline as distension media between March 2001 and March 2009 were randomized. The clinical characteristics, laboratory data, and post-operative results were retrospectively analyzed. RESULTS: The following hysteroscopic procedures were performed: endometrial biopsy, 26; endometrial polypectomy, 8; myomectomy, 7; ablation for dysfunctional uterine bleeding and endometrial hyperplasia, 1; and excision of an endometrial mass, 1. The mean size of the myomas was 3.2 cm. The average duration of hospitalization was 2 days. The average change in hemoglobin was 1.1 g/dl. The mean operative time was 36 minutes. CONCLUSION: The indications for hysteroscopic procedures can be extended. Pure intramural myomas, submucosal myomas, endometrial polyps, adenomyosis, endometrial hyperplasia, hydrometra, and abnormal uterine bleeding can be treated via a hysteroscope. Intra-operative transabdominal ultrasonographic guidance can be helpful during hysteroscopic procedures, and reduces the complication and morbidity rates.
Adenomyosis ; Biopsy ; Endometrial Hyperplasia ; Female ; Hemoglobins ; Hospitalization ; Humans ; Hysteroscopes ; Hysteroscopy ; Menopause ; Metrorrhagia ; Myoma ; Operative Time ; Polyps ; Retrospective Studies ; Uterine Hemorrhage

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The Effect of Pomegranate on Depression, Anxiety, and Food Intake in Ovariectomized Rats.

Ki Hoon AHN ; Kyong Wook YI ; Hyun Tae PARK ; Jung Ho SHIN ; Jun Young HUR ; Young Tae KIM ; Sun Haeng KIM ; Kyu Wan LEE ; Seung Hee KIM ; Chun Sik BAE ; Tak KIM

The Journal of Korean Society of Menopause.2010;16(1):39-45.

OBJECTIVES: To determine whether or not pomegranate extract can affect depression, anxiety, and food intake in ovariectomized rats. METHODS: Seventy-nine female Sprague-Dawley rats were divided into six groups: A, no operation and no drug intake; B, sham operation and distilled water; C, ovariectomy and distilled water; D, ovariectomy and 10% dilute pomegranate extract; E, ovariectomy and 20% dilute pomegranate extract; and F, ovariectomy and 40% dilute pomegranate extract. Beginning 2 days after surgery, drugs were administrated for 4 weeks. After that, the rats were subjected to the elevated plus maze (EPM) test and forced swim test (FST). RESULTS: The 10% pomegranate extract had a lower % closed arm entry frequency in the EPM test. A pomegranate dose-dependent decrease in the duration of immobility duration in FST was shown. Pomegranate did not reverse ovariectomy-related hyperphagia and weight gain. CONCLUSION: Pomegranate extract improved depression and anxiety in a postmenopausal model with ovariectomized rats.
Animals ; Anxiety ; Arm ; Depression ; Eating ; Female ; Humans ; Hyperphagia ; Ovariectomy ; Punicaceae ; Rats ; Rats, Sprague-Dawley ; Salicylamides

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