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

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

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

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

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

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

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

OBJECTIVES: To assess the ability of risk of malignancy index (RMI) 1 to discriminate between benign and malignant pelvic masses. METHODS: Between January 2007 and December 2010, 547 women with pelvic masses were evaluated. Their medical records are reviewed here retrospectively. The sensitivity, specificity and positive and negative predictive values of the cancer antigen (CA) 125 level, ultrasound findings and menopausal status in the prediction of malignant pelvic masses were calculated and compared individually or combined using the RMI 1. RESULTS: The receiver operating characteristic (ROC) curves of CA 125, the ultrasound score and the RMI 1 were all found to be relevant predictors of malignancy. ROC analysis of the RMI 1, CA 125 serum levels, ultrasound score and menopausal status showed areas under the curves of 0.795, 0.782, 0.784 and 0.594, respectively. The RMI 1 was found to be statistically significantly correlated with menopausal status (P = 0.001), while not statistically significantly correlated with CA 125 (P = 0.628) or the ultrasound score (P = 0.541). The RMI 1 at a cut-off of 150 - with a sensitivity of 77.9%, specificity of 81.1%, positive predictive value of 51.7% and negative predictive value of 93.4% - showed the highest performance in determining the malignant tendency of pelvic masses. CONCLUSION: Accepting a RMI 1 cut-off value of 150 results in statistically more significant diagnostic criteria than menopausal status for the discrimination of benign and malignant pelvic masses.
Discrimination (Psychology) ; Female ; Humans ; Medical Records ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

OBJECTIVES: This study was performed to consider the clinical experience of an ultrasound-guided vacuum-assisted resection (Mammotome) for benign breast lesions through a core needle biopsy. METHODS: The authors carried out a core needle biopsy and Mammotome for 347 patients and investigated the pathologic results. RESULTS: The significant difference of core needle biopsy and Mammotome results was demonstrated, Spearman correlation coefficient is 0.413 in a correlation analysis. CONCLUSION: This experience suggest Mammotome is a useful procedure for providing more correct pathologic findings through complete resection of benign breast lesions.
Biopsy, Large-Core Needle ; Breast ; Breast Diseases ; Breast Neoplasms ; Humans ; Mammography ; Needles

OBJECTIVES: Phytoestrogen-containing pulse supplements have beneficial effects on postmenopausal symptoms, but how such effects are achieved is unclear. This study investigates the effects of pulse consumption on the menopausal changes in ovariectomized rats. METHODS: Female Sprague-Dawley rats were either sham operated (Sham; n = 3) or surgically ovariectomized (n = 13). The Sham group was fed the regular AIN-93M diet. Ovariectomized group was divided into 3 sub-groups and fed AIN-93M containing soybean (n = 5), mung bean (n = 3), or cowpea (n = 5) for 10 weeks. At the end of the experiment, all rats were sacrificed, and the uterus was harvested, rinsed, and weighed. Expressions of vitamin D receptor (VDR), estrogen receptor (ER) beta, and ezrin in uterus were evaluated by immunohistochemistry. RESULTS: VDR was highly expressed in the uterus of rat, irrespective of ovariectomized state. VDR was more definitely expressed in the uterus of ovariectomized groups than the sham-operated group. There were no significant differences in expression of ER beta. However the expression of ezrin was highly expressed in the cowpea group compared to sham group (P = 0.044). CONCLUSION: This study suggested that legumes diet may concern menopausal changes via VDR and ezrin. The result may partly explain the beneficial effects of VDR on menopausal symptoms. Further study is necessary to study the detailed mechanisms of VDR and ezrin on the menopausal changes in the uterus.
Animals ; Cytoskeletal Proteins ; Diet ; Estrogens ; Fabaceae ; Female ; Humans ; Menopause ; Mice ; Rats ; Rats, Sprague-Dawley ; Receptors, Calcitriol ; Salicylamides ; Soybeans ; Uterus ; Vitamin D ; Vitamins