Common Causes of Postmenopausal Bleeding in Korean Women: 10-Year Outcomes from a Single Medical Center

The common causes of postmenopausal bleeding (PMB), according to the data from the western world, are atrophy, hormone replacement therapy (HRT), endometrial cancer, etc. We conducted a retrospective study to assess whether the causes of PMB in Korean postmenopausal women are similar to those already known. This retrospective study used 10-year medical records (March 2005 to December 2014) of 792 PMB women in the Yonsei University Health System. The data were divided into 2 categories by 5-year intervals to compare the differences between the 2 periods. The most common cause of PMB in Korean women was atrophy (51.1%). Polyps and HRT were the second, followed by anticoagulant medications, cervical cancer, and endometrial cancer. The proportion of patients with cervical cancer significantly decreased during the second half of the decade (8.7% vs. 5.2%; P = 0.048). Although no significant change was noted for HRT, its rank was higher during the latter 5-year period. Only the most common cause of PMB was the same as the conventional data. Interestingly, the proportion of patients with cervical cancer decreased during the latter half of the decade, reflecting the changes in the nation's cancer prevalence rate, while the use of HRT increased.

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.

The Relationship between Polymorphisms in Tumor Necrosis Factor (TNF) Genes and Changes in Bone Mineral Density after Hormone Therapy in Postmenopausal Korean Women / 대한골다공증학회지

OBJECTIVES: To determine the association between polymorphisms in tumor necrosis factor-alpha (TNF-alpha), and TNF-beta genes, and changes in bone mineral density (BMD) after hormone therapy (HT) in postmenopausal Korean women. MATERIALS & METHODS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or Taqman assay in 218 postmenopausal Korean women receiving sequential HT for 1 year. Bone mineral density (BMD) at the lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. Serum levels of bone specific alkaline phosphatase (BAP), osteocalcin (OST), type I C-telopeptide breakdown products (CTX), parathyroid hormone (PTH), calcium, and phosphorus were measured using enzyme-linked immunosorbent assay (ELISA), immunoassay, and atomic absorptiometry, respectively. RESULTS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or Taqman assay in 218 postmenopausal Korean women receiving sequential HT for 1 year. Bone mineral density (BMD) at the lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. Serum levels of bone specific alkaline phosphatase (BAP), osteocalcin (OST), type I C-telopeptide breakdown products (CTX), parathyroid hormone (PTH), calcium, and phosphorus were measured using enzyme-linked immunosorbent assay (ELISA), immunoassay, and atomic absorptiometry, respectively CONCLUSIONS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms are not associated with changes in BMD after HT in postmenopausal Korean women.