Prevalence of climacteric symptoms according to years after menopause.

OBJECTIVE: To study the prevalence of menopausal symptoms of women attending the menopause and gynecology clinics at Chulalongkorn Hospital. STUDY DESIGN: A descriptive study was conducted at the menopause and gynecology clinics at Chulalongkorn Hospital. After inclusion and exclusion were done, four hundred and twenty seven participants with premenopause, perimenopause and postmenopause were studied. All the women were classified into seven groups of premenopause, perimenopause and one, two, three, four and > or =five years after menopause. The interview was performed by well-trained social workers using standardized questionnaires. RESULTS: The average age at menopause of the postmenopausal women was 49.46 + 3.30 years. Prevalence of vasomotor symptoms eg. hot flushes in premenopause, perimenopause and one, two, three, four and > or =five years after menopause were 4.4 per cent, 25 per cent, 27.3 per cent, 38.8 per cent, 40 per cent, 11.1 per cent and 10.3 per cent, respectively. Prevalence of psychological symptoms eg. moodiness were 26.5 per cent, 25 per cent, 54.6 per cent, 38.7 per cent, 32.2 per cent, 11.2 per cent and 11.8 per cent, respectively. But the prevalence of headache in this category was 29.4 per cent, 23.3 per cent, 23.7 per cent, 22.6 per cent, 25.0 per cent, 11.1 per cent and 13.2 per cent, respectively. Prevalence of urinary symptoms seemed to increase continuously after menopause. Prevalence of genital symptoms eg. vaginal dryness were 5.9 per cent, 13.3 per cent, 25.5 per cent, 25.8 per cent, 15.0 per cent, 16.7 per cent and 20.6 per cent, respectively. Prevalence of other symptoms eg. muscle and joint pain were 22.1 per cent, 43.3 per cent, 56.4 per cent, 58.0 per cent, 45.0 per cent, 27.8 per cent and 28.0 per cent, respectively. CONCLUSION: The prevalence of menopausal symptoms in this postmenopausal group appeared to increase during the first and second years after menopause and tended to decrease afterwards. The prevalence of other symptoms eg. dry eyes and headache appeared to be unchanged after menopause.

Difference in bone acquisition among hormonally treated postmenopausal women with normal and low bone mass.

This prospective analysis was conducted to compare the effects of hormone treatments on bone mineral density (BMD) of the lumbar spine, hip, and distal forearm in postmenopausal women with normal BMD and those with low bone mass. Eighty healthy women were randomly assigned to receive a cyclic regimen of standard hormone replacement therapy (HRT) or currently used low-dose oral contraceptive (OC). Women were categorized as normal BMD and low bone mass according to the Thai reference database. The results revealed that women with low bone mass gained more BMD than those with normal BMD. The difference in mean per cent bone acquisition was obvious at the spine. In addition, further subset analysis into OC and HRT groups revealed higher effects of OC on BMD when compared to HRT.

An effect of hormone replacement therapy on skin thickness in early postmenopausal women.

BACKGROUND: It is well known that dermal thickness, the major component of skin thickness, will decrease progressively after menopause. Bone and dermis share a similar organic constituent (collagen type I). The effect of hormone replacement therapy on bone has been established, whereas, its effects on skin are less well-described. This study was performed to determine the effect of combined estrogen-progestin replacement therapy in a sequential regimen on skin thickness in women during the early postmenopausal period. METHOD: One hundred early postmenopausal women who met the eligibility criteria and had already signed a consent form were non-randomly allocated in two groups. Group A; sixty women who received cyclic hormone replacement therapy in each 28-day cycle for 6 cycles. Group B; forty women who received 1,000 mg of calcium carbonate daily. Skin thickness was measured by ultrasonography before and after treatment and the Student's t-test was used to compare the results. RESULTS: A statistically significant increase in skin thickness over baseline was noted after combined estrogen-progestin replacement therapy had been administered for 24 weeks compared to the control and baseline groups. The skin thickness was also significantly decreased after calcium had been administered for 24 weeks when compared to baseline. CONCLUSION: Skin thickness was increased in early postmenopausal women subjected to hormone replacement therapy with an alternating dose of estrogen and progestin.

Bone mineral density of lumbar spine and proximal femur in normal Thai women.

OBJECTIVE: To find the reference data for age-specific normal bone mineral density in a Thai female population. STUDY DESIGN: Cross-sectional, Descriptive study. MATERIAL AND METHOD: 1773 Thai women aged between 11-80 years were recruited, using multistage cluster sampling and stratifying from six represented provinces in the country, each strata was randomly selected. After recruiting, the women were interviewed by well-trained personnel using structured questionnaires. Bone mineral density of the lumbar spine 1-4 and nondominant hip were measured by Dual Energy Photon Absorptiometer. The scientists, X-rays technician were trained and standardized inter and intra observers variation. Quality control of examination was measured periodically. Every BMD outcome was re-examined by a specialist. RESULTS: The peak bone mineral density of both spines and hips was between the age of 30 to 34 years old. Mean Value for spine and femoral neck was 0.957 and 0.814 g/cm2 respectively. The BMD of spine and hip was significantly decreased after the age of 35 and the loss was accelerated at age 50. Osteoporosis for spine and femoral neck is considered when BMD are below 0.682 and 0.569 g/cm2 respectively. CONCLUSION: The results are important data for public health policy, by maximizing bone mass during skeletal growth before menopause and minimizing bone loss throughout life as well as for detection of important risk factors.

Comparison of norgestrel- versus cyproterone acetate-containing hormone replacement therapy on lipid-lipoprotein metabolism.

To compare the effects on the lipid profile of estradiol valerate with norgestrel to a regimen of estradiol valerate with cyproterone acetate. Sixty-four healthy women in their perimenopause or early postmenopause, aged between 40-55 years, were randomized to one of the two 21-day sequential regimens: estradiol valerate 2 mg/day for 21 days and combined with either norgestrel 0.5 mg/day or cyproterone acetate 1 mg/day from day 12 to 21, with 7 days of drug-free interval, for 12 cycles. Lipid profiles were followed at baseline, 6 and 12 cycles. Sixty-one subjects completed the study, 30 in the norgestrel group and 31 in the cyproterone group. During 12 cycles of study, serum HDL cholesterol levels decreased significantly in the norgestrel group (p < 0.01) and were unchanged in the cyproterone group. The levels were significantly lower in the norgestrel group than in the cyproterone group (p < 0.05). No differences were found between groups as regards LDL cholesterol and total cholesterol levels. Triglyceride levels decreased significantly in the norgestrel group (p < 0.01), remained unchanged in the cyproterone group and the levels were significantly different between groups (p < 0.01). In conclusion, the study demonstrated that sequential regimen of estradiol valerate with norgestrel produced less favorable HDL cholesterol but more favorable triglyceride levels than the regimen of estradiol valerate with cyproterone acetate.

Uterine blood flow response to hormonal replacement therapy in asymptomatic postmenopausal women: a transvaginal Doppler study.

To evaluate the effect of continuous hormonal replacement therapy (HRT) on Doppler parameters of uterine blood flow in asymptomatic postmenopausal women. Thirty-eight asymptomatic postmenopausal women were recruited into the study from the outpatient menopause clinic, Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University. The study population was divided into 20 cases without any HRT (group 1) and 18 cases using continuous conjugated equine estrogen 0.625 mg/day combined with medroxyprogesterone acetate 2.5 mg/day (group 2). The duration of HRT was 21.3 +/- 9.5 (13-56) months. A transvaginal colour flow imaging system (ALOKA SSD-2000 MultiView, Tokyo, Japan) was used to assess uterine blood flow. Quantitative data from areas of colour were evaluated by pulsed Doppler spectrum analysis. Resistance indices (RI) were measured as indicators of uterine perfusion. Both groups were statistically similar with respect to age, parity, age at menopause, height and weight. The endometrial thickness in group 1 and 2 were 3.8 +/- 0.8 and 4.1 +/- 0.6 millimetres, respectively. The left uterine artery RIs of group 1 and 2 were 0.86 +/- 0.08 and 0.84 +/- 0.07, respectively (p = 0.33). The right uterine artery RIs of group 1 and 2 were 0.87 +/- 0.07 and 0.83 +/- 0.06, respectively (p = 0.06). In conclusion, continuous HRT had a non-significant influence on uterine blood flow in the postmenopausal women.

Dyslipidemia among healthy postmenopausal Thai women.

A prospective analysis was conducted to assess the prevalence of dyslipidemia among 80 healthy postmenopausal Thai women who were not more than five years after menopause. Serum total cholesterol, triglycerides and high-density lipoprotein (HDL) cholesterol were measured using enzymatic procedures. Low-density lipoprotein (LDL) cholesterol concentration was estimated by Friedewald formula. The results showed that 91.25 per cent, 10.00 per cent, 38.75 per cent and 48.75 per cent of the studied population had total cholesterol > or = 200 mg/dl, triglycerides > or = 150 mg/dl, HDL < 50 mg/dl, and LDL > or = 190 mg/dl respectively. Of all the women, 77.50 per cent and 10.00 per cent had total cholesterol / HDL ratio of > or = 4 and had triglyceride levels of > or = 150 mg/dl with HDL < 50 mg/dl, respectively. This unexpected high prevalence of dyslipidemia in this healthy postmenopausal group should be taken into account in considering health promotion strategies for postmenopausal Thai women particularly those in the high risk group.

The predictive value of skin thickness in the diagnosis of osteopenia.

Skin and bone share a similar organic constituent (type I collagen) which decreases with time after menopause due to hypoestrogenism. The interdependence of skin and bone atrophy has been reported. This study was conducted to assess the predictive value of an ultrasonographic measurement of skin thickness in the diagnosis of osteopenia (BMD below -1.5 SD.) in perimenopausal and early postmenopausal women. All patients had skin thickness measured by the same radiologist and had a dual-energy X-ray absorptiometry (DEXA) scan of the lumbar spine and the femoral neck. Of the 77 women studied, the mean age was 50.9 +/- 3.0 years. Thirty patients were in perimenopause and 47 in early postmenopause. Mean skin thickness was 2.1 +/- 0.4 mm. Women with a skin thickness of < or = 1.7 mm carried a higher risk for developing osteopenia at the lumbar spine (odds ratio 8.41, 95% confidence interval 2.19-32.35) and the femoral neck (odds ratio 3.88, 95% CI 1.14-13.17). Patients with a skin thickness of > or = 2.4 mm had a lower probability of osteopenia at the lumbar spines (odds ratio 0.17, 95% CI 0.035-0.845) and the femoral neck (odds ratio 0.22, 95% CI 0.055-0.899). In conclusion, a low skin thickness measurement by ultrasonography may be used as an indicator for osteopenia in perimenopausal and early postmenopausal women.

Skin thickness in different menopausal status.

It is well known that skin thickness will decrease in the years after menopause. Women may have climacteric symptoms including those associated with skin alterations as early as during the perimenopausal period. This study was performed to compare the skin thickness of women in their premenopause (N = 31), perimenopause (N = 35) and early postmenopause (N = 46). The mean skin thickness in each group was 2.28 +/- 0.39 mm., 2.18 +/- 0.35 mm. and 2.02 +/- 0.36 mm. respectively. The skin thickness of women in the early postmenopausal group was significantly lower than those in the premenopausal group, but no difference was found between premenopausal and perimenopausal group nor between perimenopausal and early postmenopausal group. Furthermore, we found no correlation between skin thickness and chronological age. In conclusion, the decline in skin thickness of women entering menopause requires a period of time to undergo significant alterations and the study revealed a significant reduction of skin thickness as early as in the course of the early postmenopausal period.

Estradiol and follicle-stimulating hormone levels in oophorectomized women applying percutaneous 17 beta-estradiol over the medial surface of the left arm.

To assess the changing estradiol (E2) and follicle stimulating hormone (FSH) level in oophorectomized women applying percutaneous 17 beta estradiol over the medial surface of the left arm. Thirty-nine women, who had undergone total abdominal hysterectomy and bilateral oophorectomy after 4 weeks, were enrolled into the study. All subjects received a daily dose of 1.5 mg percutaneous 17 beta-estradiol in 2.5 g of the gel, applied over the medial surface of the left arm in the limited area of 150 cm2. Serum E2 and FSH were measured before and after commencing the study at weeks 4, 8 and 12. The measurement was performed 12-14 hours after the gel application, using time-resolved fluoroimmunoassay (FIA) method. Serum E2 significantly increased from the baseline value at weeks 4, 8 and 12 (Median of E2 value at weeks 0, 4, 8 and 12 = 47.30, 86.78, 128.00 and 163.15 pmol/L, respectively, P < 0.05). While the serum FSH level significantly decreased. (Median of FSH value at weeks 0, 4, 8 and 12 = 66.05, 60.40, 53.35 and 48.40 IU/L, respectively, P < 0.05). In conclusion, this dose, duration and route of estrogen administration increased the serum E2 level close to the early to mid-follicular phase of the normal menstrual cycle. While FSH level significantly decreased but did not reach the premenopausal range.

Postmenopausal osteoporosis: what is the real magnitude of the problem in the Thai population?

To assess the prevalence of osteoporosis, bone mass measurement was performed on 1,047 women attending a menopause clinic at Chulalongkorn Hospital, Bangkok. The mean age of the population was 50.5 +/- 5.7 years. The bone density was measured at lumbar spines (LS) (L1-L4) and the non-dominant femoral neck (FN) site utilizing a Hologic QDR 2000 dual energy X-ray absorptiometer. According to the World Health Organization's (WHO) definition a value of bone mineral density (BMD) that is more than 2.5 standard deviation (SD) below the young adult mean is considered diagnostic of osteoporosis. In this study, Thai and American cut-off values of BMD for osteoporosis were used to compare the prevalence of osteoporosis. Using Thai's cutoff value, the results showed a lower prevalence of osteoporosis of both LS and FN (15.7% and 9.5%, respectively). Considering the subgroups of the studied population, the prevalence of osteoporosis of LS and FN utilizing Thai's cutoff value was significantly higher in postmenopausal than in premenopausal women. (Premenopause vs postmenopause, LS: 4.7% vs 21.4%; FN: 4.7% vs 11.9%, respectively, P < 0.05) WHO's definition of osteoporosis (the cutoff value of 2.5 SD below the young adult mean) is based on the rationale that this cutoff value identifies approximately 30 per cent of postmenopausal white women as having osteoporosis which is approximately equivalent to the lifetime risk of fracture at the spine, hip and forearm of white women at age 50 years. The prevalence of osteoporosis obtained in this study might not represent the true magnitude of the problem in Thailand. Until we have our own lifetime fracture risk which will enable us to have an appropriate cutoff value to diagnose osteoporosis, this prevalence might be used as an approximate figure or initial information for further research in this field.

Similarity of bone mass measurement among hip, spines and distal forearm.

From January-December 1995, bone mineral density (BMD) of lumbar spine, hip and distal forearm were studied in 325 healthy women visiting the menopause clinic, Chulalongkorn Hospital. This retrospective analysis was conducted to assess the correlation of BMD among various measurement sites. Bone mass measurement at hip and spine were performed utilizing dual energy X-ray absorptiometer (DEXA), Hologic QDR 2000 and at distal forearm by single energy X-ray absorptiometer (SEXA), Hologic DTX 100. By canoconical correlation, the results revealed a significant correlation of BMD of distal and ultra-distal part of forearm with various sites of hip (r = 0.602, p < 0.001). There was also significant correlation of distal and ultra-distal part of forearm with various sites of spines (r = 0.619, p < 0.001). Though there is some heterogeneity of bone mass density among different measurement sites, practically with this fairly good level of correlation, bone mass measurement of distal forearm might be used to predict the BMD of hip and spine in Thai women. The accuracy of predicting the BMD of hip and spine by BMD of distal forearm in the mass screening programme in Thailand is now going on. The results will be followed.

Estradiol and follicle-stimulating hormone levels in oophorectomized women using vaginal estrogen.

To assess the changing estradiol (E2) and follicle-stimulating hormone (FSH) level in oophorectomized women using vaginal estrogen. Serum estradiol and FSH were evaluated in 32 oophorectomized women using a daily dose of 2 g base of 1.25 mg vaginal conjugated equine estrogen (CEE) cream. The blood sample for hormone assay was collected 8-10 hours from the time of vaginal application. E2 and FSH levels were measured in the serum sample before and after commencing the study at 4, 8 and 12 weeks using the time-resolved fluoroimmunoassay method. Serum estradiol significantly increased from baseline value at 4, 8 and 12 weeks. (Mean +/- SD of E2 value at 0, 4, 8, 12 weeks: 9.97 +/- 12.13, 249.83 +/- 170.46, 299.38 +/- 190.65, 322.82 +/- 218.31 pmol/L, respectively, P < 0.05) On the other hand, serum FSH significantly decreased from baseline value at 4, 8 and 12 weeks. (Mean +/- SD of FSH value at 0, 4, 8, 12 weeks: 77.64 +/- 27.24, 40.33 +/- 21.64, 38.84 +/- 22.33, 30.90 +/- 24.32 IU/L, respectively, P < 0.05) In conclusion, a daily dose of 2 g vaginal CEE cream raised the serum estradiol level close to the normal level in the follicular phase of the normal menstrual cycle. However, even though FSH significantly decreased it did not reach the premenopausal level.

Bone loss in oophorectomized Thai women.

This prospective analysis was done in 95 postmenopausal women to observe bone loss rate between 59 natural and 36 surgical menopausal women with or without hormonal replacement therapy (HRT). Bone mass measurement was performed at lumbar spines (L1-L4) and hip by dual energy X-ray absorptiometer at 0, 6 and 12 months. The results revealed that in the non-HRT group there was significant faster bone loss rate of lumbar spines (LS) and hip (H) of the surgical group at 12 months (Natural group: LS = -1.11%, H = +2.38%; Surgical group: LS = -4.51%, H = -0.66%, P < 0.05). However, there was no significant difference in bone changes of lumbar spines and hip between natural and surgical group with HRT at 12 months (Natural: LS = +2.0%, H = +4.06%; Surgical: LS = +0.62%, H = +2.28%, P > 0.05). This observation showed that without HRT oophorectomized women had greater magnitude of bone loss than women who entered menopause naturally.

Correlation of bone mineral density among various measurement sites.

Bone mineral density (BMD) of the lumbar spine and hip was studied in 1,047 women visiting the menopause clinic, to assess the correlation of BMD among various measurement sites. Bone mass measurement was performed utilizing dual energy X-ray absorptiometer (DEXA), Hologic QDR 2000. The results revealed a significantly high correlation of BMD of total hip and spine. (r = 0.7021, P < 0.001) Nevertheless, BMD of the spine was mostly correlated with BMD of trochanteric site (r = 0.7235, P < 0.001) and least correlated with BMD of intertrochanteric region. (r = 0.2426, P < 0.001) In conclusion, BMD of spine and hip is highly correlated. However, there was some heterogeneity of correlation in different specific measurement sites.

Climacteric complaints of paramedical personnel.

This study was conducted from October 1995 to January 1996, to assess the prevalence of climacteric complaints of paramedical personnel in Chulalongkorn Hospital. Data collection was performed using a standardized questionnaire, comprised of population characteristics, items and severity of climacteric complaints. All the participants filled up the questionnaire by themself after receiving a clear explanation of the meaning of each symptom. Two hundred and ninety women aged 40-59 years participated in the study. Their mean age was 47.72 +/- 4.77 years. Forty six per cent of the study population were classified as premenopausal, i.e. having regular vaginal bleeding during the last 12 months, 18 per cent were perimenopausal, i.e. having irregular vaginal bleeding during the last 12 months and 35 per cent were postmenopausal, i.e. having no vaginal bleeding during the last 12 months. The mean time since menopause of the last group was 4.71 +/- 3.75 years. The results revealed that the prevalence of vasomotor symptoms, urogenital symptoms and other symptoms i.e. numbness, forgetfulness, etc, were reported at a significantly higher rate in the postmenopause than in the perimenopause and premenopause women respectively (P < 0.05). However, there was no significant difference in the prevalence of psychological symptoms among the three groups (P > 0.05). In conclusion, except for psychological symptoms, the reported prevalence of climacteric complaints in paramedical personnel was associated with menopausal status.

Symptoms and problems of menopausal women in Klong Toey slum.

This study was conducted to assess the symptoms and problems of postmenopausal Thai women in Klong Toey slum. The interview was randomly performed according to the home number by well-trained social workers and a standardized questionnaire was used. One hundred and nineteen postmenopausal women were eligible for the study. The women were of low socioeconomic and educational background. Their mean age was 58.9 +/- 6.9 years. The mean time since menopause was 7 years. The prevalence of the climacteric symptoms was as follows: vasomotor symptoms 72.3 per cent, urological symptoms 80.7 per cent, genital symptoms 87.4 per cent and psychological symptoms 98.3 per cent. However, the prevalence of severe vasomotor, urological, genital and psychological symptoms which these women recognized as problems was 29.4 per cent, 19.3 per cent, 15.1 per cent and 75.6 per cent, respectively. In conclusion, the prevalence of climacteric symptoms of postmenopausal women in Klong Toey slum were high but the symptoms which these women recognized as problems were low. These women probably perceived these symptoms as a natural change of life.

Serum estradiol and gonadotropins level in postmenopausal women with or without hormone replacement.

Serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) was measured in 49 menopausal women, to assess the changing serum level in women with or without hormone replacement. Women in the study group (N = 25) received estrogen with or without progestin. The control group (N = 24) did not receive any hormone regimen. Serum hormone measurement was done at 0, 6 and 12 month, using time-resolved fluoroimmunoassay method. The results revealed no significant change of FSH, LH and E2 at 0, 6 and 12 month in the control group. (FSH at 0, 6, 12 month: 55.14 +/- 22.82, 63.90 +/- 24.54, 72.81 +/- 29.58 IU/L, P = 0.09; LH at 0, 6, 12 month: 35.54 +/- 19.86, 33.02 +/- 16.30, 32.33 +/- 17.37 IU/L, P = 0.83; E2 at 0, 6, 12 month: 49.28 +/- 48.54, 37.29 +/- 39.93, 25.63 +/- 23.58 pmol/L, P = 0.17). However, in the study group, FSH and LH significantly decreased but E2 significantly increased at 6 and 12 months. (FSH at 0, 6, 12 month: 59.33 +/- 22.30, 27.23 +/- 16.31, 29.74 +/- 19.45 IU/L, P < 0.05; LH at 0, 6, 12 months: 41.4 +/- 17.02, 19.62 +/- 13.66, 15.65 +/- 8.77 IU/L, P < 0.05; E2 at 0, 6, 12 months: 47.33 +/- 41.25, 280.94 +/- 174.11, 270.70 +/- 198.65 pmol/L, P < 0.05). In conclusion, hormone replacement decreased serum gonadotrophin, though not reaching the premenopausal level. However, serum E2 value was significantly increased close to the level in the follicular phase of normal menstrual cycle.

The effectiveness of hormone in relieving menopausal symptoms.

To assess the effectiveness of hormone replacement in relieving menopausal symptoms, 75 natural menopausal women suffering from these symptoms were recruited for this double-blind, placebo controlled study. These women were randomized into 2 groups. In the first eight weeks, the first group received a sequential regimen of Estradiol valerate 2 mg/day for 21 days and Norgestrel 0.5 mg/day from day 12 to 21, with seven days of drug-free interval, for two cycles. In the last eight weeks, placebo was given in the same fashion. In the second group, placebo was given in the first eight weeks, then hormone in the last eight weeks. The menopausal scores were recorded by the patients at weeks 0, 4, 8, 12 and 16. Sixty women completed the 16 week study, of which there were 30 women in each group. The mean menopausal score by eight weeks decreased significantly in the first group compared to the pretreatment value (The scores at week 0 and 8 = 20.03 and 12.63 respectively, p < 0.05). However, there was no significant change of the score in the second group. (The scores at week 0 and 8 = 21.20 and 19.43 respectively, p > 0.05). After switching from hormone to placebo in the first group, there was no significant change in mean menopausal score (The scores at week 8 and 16 = 12.63 and 13.73 respectively, p > 0.05). Nevertheless, when switching from placebo to hormone in the second group, the score decreased significantly. (The scores at week 8 and 16 = 19.43 and 13.20 respectively, p < 0.05). In conclusion, this study demonstrated the beneficial effects of hormone replacement in relieving menopausal symptoms.

Hormonal replacement and lipid changes in postmenopausal women.

To assess the effect of hormonal replacement therapy on lipid changes, measurement of serum total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), apolipoprotein A-1 (Apo-A) and apolipoprotein B (Apo-B) was performed on 93 postmenopausal women. Women in the study group (HRT) (51/93) received estrogen with or without progestin. The control group (Non-HRT) (42/93) did not receive any hormone regimen. The measurement was done at 0, 6 and 12 months. The results revealed that triglyceride increased significantly more in the non-HRT than the HRT group at 6 and 12 months. (Non-HRT: +21.7%, +21.7%; HRT: -2.8%, +2.4%, respectively P < 0.05). However, there was no significant difference in changes of other lipid profiles between the two groups at 6 and 12 months (Non-HRT: TC -2.7%, +0.7%, HDL +2.9%, +5.1%, LDL -5.2%, -4.1%, Apo-A +0.5%, +0.9%, Apo-B +3.8%, +1.3%: HRT: TC -1.4%, -2.8%, HDL +4.7%, +6.2%, LDL -1.5%, -4.9%, Apo-A -0.9%, +1.6%, Apo-B -2.6%, -1.6%, respectively P > 0.05). The paradoxical changes of triglyceride and HDL might partly be explained by the effect of progestins used in this study.