The Trend in the Sales of Menopausal Hormone and Other Osteoporosis Medications in South Korea from 2016 to 2019

Background@#Increasing geriatric population, osteoporosis prevalence, and interest in bone health are key contributing factors for the growth of osteoporosis medication markets. Thus, this study evaluated changes in the menopausal hormone and other osteoporosis medication markets from 2016 to 2019. @*Methods@#This study’s dataset was obtained from the International Marketing Services of IQVIA Inc. in South Korea. The sales of medications for osteoporosis treatment with menopausal hormones were evaluated for drug sales for osteoporosis treatment from 2016 to 2019. @*Results@#The results showed that the tissue-selective estrogen complex (TSEC) sales had increased annually while the estrogen-progesterone therapy (EPT) sales had decreased. Excluding menopausal hormones, bisphosphonates were the most widely sold medications for osteoporosis treatment. Among the bisphosphonate medications, sales of ibandronate and zoledronate increased annually, while alendronate and risedronate decreased. Teriparatide also showed increasing sales. A rapid rise was noted in the sales of denosumab. @*Conclusions@#While the sales of TSEC, injectable bisphosphonates, and denosumab have increased annually, the sales of EPT, estrogen therapy, oral bisphosphonates have not increased, as reflected in hormone therapy and osteoporosis medication market trends. This study showed the recent trends in hormone therapy and the osteoporosis medication market from 2016 to 2019 in South Korea.

The Trend in the Sales of Menopausal Hormone and Other Osteoporosis Medications in South Korea from 2016 to 2019

Background@#Increasing geriatric population, osteoporosis prevalence, and interest in bone health are key contributing factors for the growth of osteoporosis medication markets. Thus, this study evaluated changes in the menopausal hormone and other osteoporosis medication markets from 2016 to 2019. @*Methods@#This study’s dataset was obtained from the International Marketing Services of IQVIA Inc. in South Korea. The sales of medications for osteoporosis treatment with menopausal hormones were evaluated for drug sales for osteoporosis treatment from 2016 to 2019. @*Results@#The results showed that the tissue-selective estrogen complex (TSEC) sales had increased annually while the estrogen-progesterone therapy (EPT) sales had decreased. Excluding menopausal hormones, bisphosphonates were the most widely sold medications for osteoporosis treatment. Among the bisphosphonate medications, sales of ibandronate and zoledronate increased annually, while alendronate and risedronate decreased. Teriparatide also showed increasing sales. A rapid rise was noted in the sales of denosumab. @*Conclusions@#While the sales of TSEC, injectable bisphosphonates, and denosumab have increased annually, the sales of EPT, estrogen therapy, oral bisphosphonates have not increased, as reflected in hormone therapy and osteoporosis medication market trends. This study showed the recent trends in hormone therapy and the osteoporosis medication market from 2016 to 2019 in South Korea.

Effects of Combination Therapy of Alendronate and Hormonal Therapy on Bone Mineral Density in Postmenopausal Korean Women: Multicenter, Randomized Controlled Clinical Trial

This study evaluated the effects of combination treatment with alendronate (ALEN) and hormone therapy (HT) on bone mineral density (BMD) in postmenopausal Korean women. This multicenter, randomized, controlled clinical trial enrolled 344 postmenopausal women with low BMD. The women received HT (0.625 mg/day of conjugated equine estrogen and 2.5 mg/day of medroxyprogesterone acetate) alone or in combination with ALEN (10 mg/day) for 1 year. Changes in BMD and biochemical markers of bone turnover were evaluated. Data from 203 women (HT alone, 99; combination treatment, 104) who completed this study were analyzed. BMD at the lumbar spine and total hip increased significantly in both treatment groups after 1 year. There were no significant differences between HT alone vs. the combination of ALEN and HT in mean BMD increase at the lumbar spine (6.9% vs. 7.9%) and total hip (3.7% vs. 3.8%). Combined therapy suppressed serum osteocalcin and urinary deoxypyridinoline to a greater extent than HT alone. In conclusion, compared to HT alone, combination treatment with ALEN and HT for 1 year did not offer a benefit in BMD in postmenopausal Korean women with low BMD.

Prevalence of Sarcopenia Adjusted Body Mass Index in the Korean Woman Based on the Korean National Health and Nutritional Examination Surveys

BACKGROUND: The purpose of this study was to determine cut-off point of appendicular skeletal muscle mass (ASM) adjusted body mass index (BMI) for sarcopenia in the Korean women and evaluate the prevalence of sarcopenia in postmenopausal women. METHODS: This study was based on the data obtained from 2008 to 2011 Korean National Health and Nutrition Examination Survey (KNHANES) IV and V. A whole body dual energy X-ray absorptiometry (DXA) scan and measurement of BMI were performed on individuals of ≥10 years old. Five thousand, two hundred and fifteen women older than 50 years were included in the study. ASM was obtained by adding the muscle masses of the four limbs. To determine the young reference group, mean and standard deviation of ASM and ASM/BMI by ages was measured. We calculated the prevalence rate of sarcopenia by each age group according to the cut-off point based on ASM and ASM/BMI. RESULTS: In determining the cut-off values related ASM/BMI, using the value that is two standard deviations below mean values for young reference group (20's and 30's) thus recommends 0.50 m² in women. The overall prevalence among women older than 50 years was 15.6%. Among women older than 65 years prevalence of sarcopenia was 22.9%. CONCLUSIONS: The prevalence of sarcopenia among Korean women obtained in this study is within the proper range of value to research about sarcopenia. Furthermore, using 0.50 m² as the cut-off value can help compare various studies about sarcopenia in Korea.

Prevalence of Sarcopenia in the Korean Woman Based on the Korean National Health and Nutritional Examination Surveys

BACKGROUND: The criteria for defining sarcopenia vary among studies and confusion has arisen when defining the cutoff value. As a result, the prevalence of sarcopenia differs markedly depending on the definition. This study used the Asian Working Group for Sarcopenia (AWGS) definition to determine the prevalence of sarcopenia among Korean women. METHODS: This study was based on data obtained from the 2008 to 2011 Korean National Health and Nutrition Examination Surveys IV and V. We used the AWGS recommended cutoff value of 5.4 kg/m2 to determine the prevalence of sarcopenia in Korean women. RESULTS: The prevalence rates of sarcopenia using a cutoff value of 5.4 kg/m2 were 385 (19.5%) in women in their 50s, 286 (16.6%) in women in their 60s, 293 (23.7%) in women in their 70s, and 91 (30.8%) in women > or =80 years. The prevalence rates of sarcopenia were 307 (19.0%) in women 65 to 74 years, 194 (27.4%) in women 75 to 84 years, and 32 (40.5%) in women > or =85 years. The overall prevalence among women >50 years was 20.2%. The prevalence of sarcopenia in women >65 years was 22.1%. CONCLUSIONS: The prevalence of sarcopenia among Korean women was within the range of values of previous research about sarcopenia. Furthermore, using 5.4 kg/m2 as the cutoff value was useful to compare various studies about sarcopenia in Koreans.

The Effect of Eqoul, a Metabolite of Isoflavone, on Endothelial Cell-independent Vasodilatation of Human Uterine Artery In Vitro

BACKGROUND: The purpose of this study is to investigate 1) whether equol has the direct modulation on vascular tone of endothelium-denuded human uterine artery, and 2) if present, whether this equol-induced modulation of vascular tone is mediated by intracellular calcium modulation through Ca2+ & K+ channels on vascular smooth muscle cell membrane. METHODS: The uterine arteries were obtained at the time of hysterectomy from 15 women. The uterine smooth muscles were pretreated with phenylephrine, 10(-5) M & high KCl solution 70 mM. The equol at 6 different concentrations from 10(-11) to 10(-6) M were used for the evaluation of modulatory action of equol on precontracted vascular smooth. The cumulative concentration-response for equol were determined on phenylephrine-induced contractions and compared with the results without pretreatment. RESULTS: Equol 10(-11) to 10(-6) M in concentration showed relaxation effect on vascular smooth muscle contraction which was induced by phenylephrine 10(-5) M. This relaxation effect of equol was dose-dependent. Equol in same concentrations showed no significant effects on vascular smooth muscle contraction induced by high KCI solution. Phenylephrine-induced contraction was markedly reduced from 10(-7) to 10(-4) M in concentration by pretreatment of equol, but high KCI-induced contraction was not affected by pretreatment of equol. CONCLUSIONS: This vasodilatation effect of equol may be induced by calcium antagonistic action, which was mediated through antagonistic action for receptor-dependent Ca2+ channel, but not for voltage-dependent Ca2+ channel. As far as we know, this is the first report of phytoestrogen equol on vascular reactivity of human vessels.

The Reference Value of Skeletal Muscle Mass Index for Defining the Sarcopenia of Women in Korea

BACKGROUND: Sarcopenia is considering important disease entity in elderly. Several study groups define the sum of the muscle masses of the four limbs as appendicular skeletal mass (ASM) to calculate skeletal muscle index (SMI). The purpose of this study was to determine cut point of SMI for sarcopenia in Korean women. METHODS: This study was based on data obtained from the 2008 to 2011 Korean National Health and Nutrition Examination Survey (KNHANES) IV and V. A whole body dual energy X-ray absorptiometry scan were performed on individuals of > or =10 years old from July 2008 to May 2011. In the analysis, 11,633 women were included. ASM was calculated and SMI was obtained as ASM/height2. Cutoff value was defined two standard deviations below mean values for young reference group. RESULTS: Of 11,633 women aged 10 to 97 years, mean and standard deviation of year was 46.73+/-18.54 years. The highest level of height was noted in 20's and the highest total sum of skeletal mass was seen 14.87 kg in 40's. The highest value of SMI was noted in 60's in Korean women. Cutoff value as mean value of young women was decided with SMI of 30's and 40's that have peak ASM. Mean and standard deviation of SMI in those ages was 5.9+/-0.7 kg/m2. A SMI of two standard deviations below the mean SMI of reference groups was 4.4 kg/m2 as cutoff value. CONCLUSIONS: This study shows that 4.4 kg/m2 of SMI in Korean women was cutoff value of sarcopenia. Further study is clearly required to decide cutoff value of SMI for sarcopenia, especially for Korean women.

Prevalence of Sarcopenia in Healthy Korean Elderly Women

BACKGROUND: We evaluated the prevalence of sarcopenia, presarcopenia, and severe sarcopenia in healthy Korean elderly women. METHODS: We measured the muscle mass and muscle function of 196 ambulatory women over the age of 65 years who visited the University Hospital Menopause Clinic. Appendicular skeletal muscle mass was measured by dual energy X-ray absorptiometry to measure skeletal muscle mass index (SMI). Assessment of hand grip strength (HGS) of the dominant hand was performed to measure the muscle strength, and 4-m straight on-way path was used to measure gait speed for physical performance. The values used to define the presarcopenia, sarcopenia, and severe sarcopenia were based on the cutoff values proposed by the Asian Working Group for Sarcopenia (AWGS). RESULTS: The mean age of women was 71.2 years, and the mean SMI in 196 women was 5.94 kg/m2. The average HGS was 20.3 kg, and the mean gait speed was 1.08 m/sec. In 41 out of the 196 women (20.9%), the SMI was reduced to less than 5.4 kg/m2. Fifty-nine women (30.1%) had HGS of less than 18 kg, and gait speed was less than 0.8 m/sec in 12 women (6.1%). Twenty-six women (13.3%) were classified into the presarcopenia stage, and 15 women (7.6%) were classified into the sarcopenia stage. There was no case of severe sarcopenia. CONCLUSIONS: One out of five relatively healthy women aged more than 65 years showed a decrease in muscle mass, and 7.6% of women showed a decrease in muscle mass and strength. The sarcopenia stage was also intensified with aging.

The Demographic Changes of Menopausal and Geripausal Women in Korea

BACKGROUND: Osteoporosis and resultant fracture seems to be the most common skeletal disease, affecting female exclusively. Osteoporosis increases exponentially with menopause and age. Therefore the demographic data seems to be the most important & fundamental for the study of osteoporosis epidemiology. METHODS: This study was to analyzed population projection from 1960 to 2060. We evaluated the demographic change of female, postmenopausal and elderly geripausal population in South Korea using Korean statistical information service database as basic fundamental data for osteoporosis epidemiology. RESULTS: According to population projection, the total female population will be exceeds the total male population since 2015 and maximize up to 2030. In 2030, nearly half of female will become postmenopausal and one fourth of women elderly will be geripausal. Of total female population in 2060, the proportion of postmenopausal women will be increased up to 59.8%. CONCLUSIONS: According to population projection in South Korea, six of ten women in 2060 will be postmenopausal and seven of ten postmenopausal women geripausal. As expected to increase proportion of elderly women, dramatic rise of osteoporosis and osteoporotic fracture also expected. Health providers pay more attention to postmenopausal and geripausal women health care.

Efficacy and Safety of Weekly Alendronate Plus Vitamin D3 5600 IU versus Weekly Alendronate Alone in Korean Osteoporotic Women: 16-Week Randomized Trial

Vitamin D (vit-D) is essential for bone health, although many osteoporosis patients have low levels of 25-hydroxy-vit-D [25(OH)D]. This randomized, open-label study compared the effects of once weekly alendronate 70 mg containing 5600 IU vit-D3 (ALN/D5600) to alendronate 70 mg without additional vit-D (ALN) on the percent of patients with vit-D insufficiency [25(OH)D <15 ng/mL, primary endpoint] and serum parathyroid hormone (PTH, secondary endpoint) levels in postmenopausal, osteoporotic Korean women. Neuromuscular function was also measured. A total of 268 subjects were randomized. Overall, 35% of patients had vit-D insufficiency at baseline. After 16-weeks, there were fewer patients with vit-D insufficiency in the ALN/D5600 group (1.47%) than in the ALN group (41.67%) (p<0.001). Patients receiving ALN/D5600 compared with ALN were at a significantly decreased risk of vit-D insufficiency [odds ratio=0.02, 95% confidence interval (CI) 0.00-0.08]. In the ALN/D5600 group, significant increases in serum 25(OH)D were observed at weeks 8 (9.60 ng/mL) and 16 (11.41 ng/mL), where as a significant decrease was recorded in the ALN group at week 16 (-1.61 ng/mL). By multiple regression analysis, major determinants of increases in serum 25(OH)D were ALN/D5600 administration, seasonal variation, and baseline 25(OH)D. The least squares mean percent change from baseline in serum PTH in the ALN/D5600 group (8.17%) was lower than that in the ALN group (29.98%) (p=0.0091). There was no significant difference between treatment groups in neuromuscular function. Overall safety was similar between groups. In conclusion, the administration of 5600 IU vit-D in the ALN/D5600 group improved vit-D status and reduced the magnitude of PTH increase without significant side-effects after 16 weeks in Korean osteoporotic patients.

Awareness and Experience of Menopausal Symptom and Hormone Therapy in Korean Postmenopausal Women

OBJECTIVES: To investigate awareness and experience of menopausal symptom and hormone therapy in Korean postmenopausal women. METHODS: A total of 570 postmenopausal women were accepted our survey. The women filled out the questionnaires composed of medical and surgical history, menopausal age and symptom, demand of treatment on menopausal symptom, and personal method for overcoming the symptom. Also, we make inquiries about experience of hormone therapy, concern about hormone therapy, improvement of menopausal symptom after therapy, adverse effect, and cause of cease the therapy. RESULTS: According to the survey, 80% (456/570) of the women experienced menopausal symptom. When they felt the symptom at first, 47% (213/570) of women was 46-50 years old. The most common menopausal symptom was hot flushes (141/570). A number of Korean women regarded that menopause was a natural process of ageing (69%). Eighty two % of women thought to need to have treatment on menopausal symptom. However, only half (43%) visited doctor. The most concerned disease after menopause they had answered was osteoporosis (60%) but only 22% of women were taken regular check-up of bone mineral density. The common causes were unwilling to do treatment were concern about adverse effect (51%) and indefinite fear of cancer (32%). Moreover, many women got diverse information about menopause from the mass media than professional advice. CONCLUSION: Only a minority of Korean postmenopausal women with menopausal symptoms had taken a hormone therapy. We should provide appropriate education and counsel to Korean peri-menopause women.

A Case of Teriparatide on Pregnancy-Induced Osteoporosis

Pregnancy-induced osteoporosis is a rare disorder characterized by fragility fracture and low bone mineral density (BMD) during or shortly after pregnancy, and its etiology is still unclear. We experienced a case of a 39-year-old woman who suffered from lumbago 3 months after delivery. Biochemical evidence of increased bone resorption is observed without secondary causes of osteoporosis. Radiologic examination showed multiple compression fractures on her lumbar vertebrae. We report a case of patient with pregnancy-induced osteoporosis improved her clinical symptom, BMD and bone turnover marker after teriparatide therapy.

The Association between Subclinical Hypothyroidism and Cardiovascular Risk Factors in Post-menopausal Women / 대한폐경학회지

OBJECTIVES: The relationship between subclinical hypothyroidism and cardiovascular disease has not yet been clearly defined. This study will investigate whether or not there is a difference in the prevalence of subclinical hypothyroidism in menopausal women with respect to cardiovascular risk factors, and will furthermore analyze the relationship between cardiovascular diseases and subclinical hypothyroidism, in order to establish a foundation for subclinical hypothyroidism research. METHODS: The study subjects consisted of 713 post-menopausal women, who visited the hospital for a health check-up in 2006-2010. They were divided into a subclinical hypothyroidism group and a normal group. This study analyzed the difference in blood pressure, serum lipid, body mass index (BMI) and blood glucose level between the two groups. The data was analyzed using a two-sample t-test. RESULTS: The prevalence of subclinical hypothyroidism for menopausal women was 6.7%. The results showed no significant differences between the normal and subclinical hypothyroidism patient groups, in regards to blood pressure, BMI, and blood glucose levels (P > 0.05). However the triglyceride of serum lipid was significantly higher in the subclinical hypothyroidism group (P = 0.003). CONCLUSION: It has been confirmed that the triglyceride of the subclinical hypothyroidism group was higher than that of the normal group, and so serum lipid maintenance and caution towards cardiovascular disease is necessary for the subclinical hypothyroidism group.

The Influence of Thyroid Function on Bone Mineral Density in Korean Postmenopausal Women / 대한폐경학회지

OBJECTIVES: Osteoporosis, defined as decreased bone mass and structural deterioration of bone, increases the incidence of fractures. Recently, there have been reports suggesting that thyroid hormones are related to bone mineral density (BMD). It has been reported that low normal circulating thyrotropin (TSH) levels correlate with lower BMD and that thyroxine (T4) and bone density are negatively related. This research aims to examine the relationship between BMD and thyroid diseases and other functional changes in postmenopausal women. METHODS: The medical records of 2,279 postmenopausal women who attended the health care clinic in eight university hospitals between March 2001 and December 2007 were reviewed retrospectively. We determined the baseline characteristics of the women, including age, height, weight, and body mass index (BMI). The BMD was measured by dual-energy X-ray absorptiometry (DEXA). The correlation between the thyroid status and BMD was analyzed using the SPSS 12.0 program. RESULTS: This research used data from a relatively large number of postmenopausal women gathered in a multicenter approach. Of the thyroid functional tests, thyroid stimulating hormone (triiodothyronine or T3) and T4 correlated with BMD, while free T4 and TSH did not show a statistically significant correlation. After adjusted age, thyroid function test did not correlate with BMD. Osteopenia was significantly higher in the group with TSH below 0.5 mU/L compared with groups that had normal or high TSH. There was no statistically significant difference in lumbar BMD and total hip BMD among patients with thyroid diseases and healthy patients. CONCLUSION: The level of T3 and T4 correlated well with BMD in Korean post-menopausal women.

Study of Nurses' Knowledge and Attitudes on Hormone Replacement Therapy / 대한폐경학회지

OBJECTIVES: This study was performed to identify nurses' knowledge and attitudes on hormone replacement therapy (HRT) of menopausal women. METHODS: Data were collected from 221 nurses who were working at maternity hospitals in the whole country using questionnaires consisting of 9 questions related to menopause-related knowledge and HRT-related attitudes and knowledge. RESULTS: According to the nurses's responses, the diseases of concern in menopausal women were osteoporosis (78%), and depression (69%). Most nurses replied that the most effective treatment of menopausal symptoms is HRT, and nurses were very knowledgeable about its strengths (59%) and weaknesses (44%). Cancer was regarded as the major complication of HRT (71%), and its side effects were breast pain (77%) and vaginal bleeding (77%). Forty-six percent of nurses thought that the appropriate treatment duration of HRT is not necessary to limit the period. The most important considerations when conducting HRT were drug stability (59%) and improving the quality of life (36%). Ninety-fi ve percent of nurses responded that they personally would use HRT for menopausal treatment or would recommend their family. HRT for menopausal symptoms was being utilized before seeking medical treatment (40%) and after drug prescription (42%). CONCLUSION: Nurses have very positive attitudes about HRT but appeared to lack critical knowledge about HRT. Therefore, more educational programs for nurses about HRT should be required.

Survey on the Prevalence of Overactive Bladder in Healthy Korean Postmenopausal Women / 대한폐경학회지

OBJECTIVES: Overactive bladder (OAB) is characterized by urinary urgency, usually accompanied with frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection (UTI) or other obvious pathology. This study was performed to investigate the prevalence of OAB and the effect of hormone therapy (HT) on the OAB prevalence in healthy Korean postmenopausal women. METHODS: The frequency, nocturia, urgency, and urgency incontinence were investigated by using questionnaire in 350 healthy postmenopausal women over 45 years old among patients who visited the Department of Obstetrics and Gynecology, Chung-Ang University Hospital, between November 2010 and February 2011. RESULTS: In our study, the prevalence of OAB was 14.3% and OAB with urgency incontinence was present in 8.0% of the investigated participants. There was no difference in OAB related to older age or the presence of HT, but signifi cant difference was found in the duration of menopause (odds ratio [OR] 3.451, 95% confidence interval [CI] 1.422-8.377, P = 0.004). Higher risks for both frequency (OR 2.921, 95% CI 1.587-5.375, P = 0.001) and nocturia (OR 2.469, 95% CI 1.069-5.702, P = 0.037) were observed in OAB subjects compared to postmenopausal women without OAB. CONCLUSION: To the best of our knowledge, this is the fi rst study investigating the prevalence of overactive bladder in Korean postmenopausal women. Older age or HT did not affect the prevalence of OAB, and HT was not effective in treating the symptoms of OAB. However, the prevalence of OAB was increased with the age, duration of menopause.

Epidemiologic Survey of Menopausal and Vasomotor Symptoms in Korean Women / 대한폐경학회지

OBJECTIVES: Vasomotor symptoms (VMS) are one of the most annoying symptoms experienced by postmenopausal women. Generally, 75% of women over 50 years of age experience VMS. This study is an epidemiologic survey of menopausal symptoms and VMS in Korean menopausal women. METHODS: Survey participants were recruited from Korean provinces based on the Korean population study conducted in 2010 and using multi-level stratification by age and geographic location, and random sampling. Healthy perimenopausal and menopausal Korean women aged between 40 to 60 years and who participated in the interview survey were included in the study. The Korean version of the Menopause Rating Scale (MRS) and the Korean version of Women's Health Questionnaire (WHQ) was used to investigate the prevalence of menopausal related symptoms and to assess quality of life. RESULTS: Among the 1,500 women, 66% were classified as perimenopause, 28% as menopause, and 7% had undergone hysterectomy. Typically, 41.6% of women in perimenopause reported having experienced VMS in recent six months. About 53.1% of women in early menopause and 36.5% of women in late menopause had experienced VMS in the past six months. Whereas, 30.6% of women with hot flashes, and 27.9% of women with sweating stated that these symptoms were not related to menopause. CONCLUSION: The prevalence of VMS in Korean women seems to be less than women of Western countries. Overall subjective experience of menopause was perceived as increasingly positive with age. Awareness of menopausal symptoms appeared lower than expected. Perimenopausal and menopausal women in Korea rarely sought medical care.

Survey on the Consumption of the Phytoestrogen Isoflavone in Postmenopausal Korean Women / 대한폐경학회지

OBJECTIVES: Isoflavone is a plant-derived compound, abundant in soy food, and its character is mixed estrogenic and antiestrogenic action, so it is highlighted as an alternative to hormone replacement therapy (HRT) in postmenopausal women. The purpose of this study is to establish a foundation for isoflavone study in the future, by estimating isoflavone intake in postmenopausal women and by recommending proper isoflavone intake. METHODS: Isoflavone intake was estimated in a total of 189 Korean postmenopausal women over 50 years old, by using a food frequency questionnaire (FFQ). Data were statistically analyzed by t-test, and one-way ANOVA with Turkey's test. RESULTS: The daily average isoflavone intake level was 21.94 +/- 19.96 mg. There is no significant difference in isoflavone intake according to age. About 60 percentile of postmenopausal women intake isoflavone under 20 mg a day, and 2 percentile of postmenopausal women intake about 80 mg isoflavone. CONCLUSION: There was no definite precise amount of isoflavone for reliving postmenopausal symptom and health. But through this study, most postmenopausal women did not intake enough isoflavone, so they have to intake more isoflavone.

Estimation of the Relative Risk for Breast Cancer in Korean Women Using Gail Model / 대한폐경학회지

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.

Bone Response to Hormone Therapy according to Basal Bone Mineral Density and Previous Response to Hormone Therapy / 대한폐경학회지

OBJECTIVES: To investigate bone responses to hormone therapy (HT) according to basal bone mineral density (BMD) and previous responses to HT, as well as the frequency and clinical characteristics of HT non-responders in Korean postmenopausal women. METHODS: We retrospectively reviewed a total of 1,836 postmenopausal women who received HT from seven university hospitals. BMD data at the lumbar spine (LS), femur neck (FN), femur trochanter (FT) and total hip (TH) before HT, and at one, two, and three years after HT were collected. All patients were divided into three groups according to basal BMD: normal, osteopenia, and osteoporosis. RESULTS: Women with a greater loss of BMD during the first year of HT were more likely to gain BMD in the second year at any of the four skeletal sites. Bone responses to HT during the third year were not related to the responses during the first year. Mean BMD changes during the first year were significantly higher in the osteoporosis group, but mean BMD changes during the second year were not different between three groups except in LS. The frequency of non-responder (annual BMD losses more than 3%) during the first year was significantly higher in the normal basal BMD group. Mean basal BMDs were higher in the two-year consecutive non-responder group at LS, FN and FT, but those of the three-year consecutive non-responder group were not significantly higher except in FN. CONCLUSION: Most women who lose BMD after HT are likely to gain BMD during the next year. The frequency of non-responders is higher in the higher basal BMD group, and patients with lower basal BMD will be likely to respond better to HT.