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OBJECTIVE: Long-term protective effects of menopausal hormone therapy (MHT) at fractures with different doses and components are controversial. We analyzed the effect of MHT on the incidence of spine and femur fractures according to MHT type, age at commencement, duration and dose of hormones in Korean women. METHOD: This retrospective study evaluated propensity score-matched patients with MHT from the Korean National Health Insurance Service database. Among women aged ≥50 years with menopause between 2004 and 2007, spine and femur fracture incidence until 2017 was analyzed in 36,446 women who had received MHT for >1 year. Estrogen-progesterone therapy (EPT), estrogen-only therapy (ET) or tibolone therapy was conducted. RESULTS: EPT significantly lowered the incidence of spine and femur fractures with a conventional dose, but not with a low dose. Tibolone significantly decreased the incidence of spine fractures in women aged 50-59 years when used for >5 years, and the incidence of femur fractures in women older than 60 years when used for >3 years. ET significantly lowered the risk of femur fractures when estradiol was used for >5 years. CONCLUSION: In menopausal women, all MHT including conventional-dose EPT, ET and tibolone tended to lower the incidence of fractures. The effects, however, varied with the type of fracture and type of MHT.
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Menopausa , Pós-Menopausa , Feminino , Humanos , Incidência , Estudos Retrospectivos , Terapia de Reposição Hormonal , Estrogênios/farmacologia , Progesterona/farmacologia , Terapia de Reposição de EstrogêniosRESUMO
OBJECTIVE: This study aimed to investigate the association of hormone replacement therapy (HRT) use, type, duration and age of commencement with myocardial infarction (MI) and stroke in postmenopausal Korean women. METHODS: This nested case-control study used data from the National Health Insurance Service database to analyze 2017 data from women aged ≥50 years and diagnosed with natural menopause between 2004 and 2007. Among 356,160 eligible women, 36,446 used HRT for ≥1 year and 319,714 did not (controls). These two groups were matched 1:1 for statistical analysis. Type and duration were categorized into three categories. RESULTS: Women who started estrogen-progestogen therapy (EPT) or estrogen therapy (ET) in their 50s, or EPT or tibolone in their ≥60s exhibited a lower stroke risk than controls. MI risk was lower among women who used tibolone - regardless of duration - or EPT or ET for 1-3 years than among controls. Stroke risk was lower with tibolone use for ≥5 years or with EPT or ET use for 1-3 years or ≥5 years than non-users. CONCLUSION: Our study may support the beneficial effect of HRT by showing that Korean postmenopausal women who used HRT at a relatively younger and healthier age had a relative benefit for MI and stroke.
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Terapia de Reposição de Estrogênios , Infarto do Miocárdio , Norpregnenos , Pós-Menopausa , Acidente Vascular Cerebral , Humanos , Feminino , Infarto do Miocárdio/epidemiologia , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos de Casos e Controles , Acidente Vascular Cerebral/epidemiologia , Norpregnenos/efeitos adversos , Terapia de Reposição de Estrogênios/efeitos adversos , Idoso , Fatores Etários , Bases de Dados Factuais , Fatores de Risco , Terapia de Reposição Hormonal/efeitos adversosRESUMO
OBJECTIVES: After the 2002 Women's Health Initiative (WHI) study, the global use of menopausal hormone therapy (MHT) declined, and despite subsequent studies indicating a low risk of breast cancer, concerns about MHT usage persist. We examined the relationship between changes in MHT use and changes in the incidence of breast cancer from 2002 to 2020 in South Korea. STUDY DESIGN: This study used tumor registry information from 2002 to 2020 from the Korean Statistical Information Service and analyzed the incidence rate of invasive breast cancer in women, who were divided into two age groups: <50 and >50 years. The numbers of MHT prescriptions in Korea between 2002 and 2020 was determined from pharmacy data. RESULTS: The incidence of breast cancer per 100,000 women in South Korea increased from 34.3 in 2002 to 96.4 in 2020. Breast cancer incidence rates increased annually in both groups of women (those aged under and over 50 years), with no significant difference between the two (p = 0.614). Prescriptions for estrogen therapy (ET) in 2020 were 52.7 % lower than those in 2002. Prescriptions for estrogen-progesterone therapy (EPT) decreased by 27.9 % over the same period. Conversely, tibolone prescriptions, which had initially decreased by 25.4 % in 2004, subsequently showed a steady increase and were 93.6 % higher in 2020 than in 2002. CONCLUSION: The incidence of breast cancer increased annually in Korean women of all ages; however, the use of ET and EPT for MHT has declined since 2002, particularly the use of EPT after 2010. MHT, especially EPT, did not significantly increase the incidence of breast cancer in Korean women.
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Neoplasias da Mama , Feminino , Humanos , Idoso , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/epidemiologia , Incidência , Menopausa , Terapia de Reposição Hormonal/efeitos adversos , Estrogênios , Progesterona , Terapia de Reposição de Estrogênios/efeitos adversosRESUMO
Endometriosis (EMS) is a rare condition in postmenopausal women. The incidence of transition from EMS to malignancy is as low as 1%, with endometrial stromal tumors (ESTs) occurring at an even lower incidence of 0.7%. Undifferentiated uterine sarcomas (UUSs) are a subtype of ESTs that account for 25% of all ESTs. Extrauterine UUSs are exceptionally rare, with only a few reported cases in the literature. We present the case of a woman who underwent surgery for deep infiltrating EMS and was later diagnosed with UUS, which originated from the bladder after surgical menopause.
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OBJECTIVES: This study used the Korean National Health and Nutrition Examination Survey (KNHANES) to determine the association between fractures and low muscle mass. METHODS: This cross-sectional study used the 2010-2011 KNHANES data. Low muscle mass was defined as (appendicular skeletal muscle mass [kg]/Height² [m²]) < 5.45 kg/m², which is < 2 SD below the sex-specific mean of a young reference group. Patients with T-scores between -1.0 and -2.5 indicated osteopenia, whereas those with T-scores lower than -2.5 indicated osteoporosis. RESULTS: Out of 1,306 women enrolled in the study, 330 were diagnosed with low muscle mass according to the abovementioned diagnostic criterion. The prevalence of fractures at various sites was significantly higher in postmenopausal women with low muscle mass than in those without low muscle mass (relative risk [RR], 1.64; odds ratio [OR], 1.62; 95% confidence interval [CI], 1.06-2.48; P = 0.027). Furthermore, the prevalence of fractures was increased by the presence of osteopenia or osteoporosis in addition to low muscle mass (RR, 1.59; OR, 1.60; 95% CI, 1.02-2.49; P = 0.039) and by osteoporosis only (RR, 2.12; OR, 2.29; 95% CI, 1.11-4.70; P = 0.025). CONCLUSIONS: Fracture was more prevalent in postmenopausal women with low muscle mass than in those without low muscle mass. This finding is consistent in a subgroup analysis that included women who had osteoporosis or osteopenia. Moreover, the risk of fractures increased as low muscle mass worsened.
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BACKGROUND: We examined the relationship between vitamin D status and health-related quality of life, and explored other related factors in the general Korean population. METHODS: We used data from the 2007-2012 Korea National Health and Nutrition Examination Survey on 14,104 adults, aged 20-49 years, who had consented to serum vitamin D measurement and answered health-related quality of life questions. EuroQol-5 was used for measurement. Serum vitamin D levels were measured at intervals of 0-9.99, 10-19.99, 20-29.99, and ≥30 ng/mL. RESULTS: Participants with higher serum vitamin D (serum 25-hydroxyvitamin D) levels were significantly less likely to report problems with depression and anxiety. After adjustment for age, gender, income level, education level, marital status, alcohol consumption, smoking status, and the existence of depressive disorders, the odds ratio for reporting a problem with depression and anxiety was 0.60 (95% confidence interval [CI], 0.39-0.91). The odds ratio for the prevalence of any problem was 0.69 (95% CI, 0.53-0.89) before adjustment, but was not statistically significant after adjustment. No significant associations were observed for problems with mobility, self-care, usual activity, or pain and discomfort. CONCLUSION: This is the first study to examine the associations between vitamin D and health-related quality of life for the general Korean population. Vitamin D status was not significantly associated with the dimensions of EuroQol-5 except for depression and anxiety problems.