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62 A HORMONAL THERAPY COMPLIANCE SURVEY AT A UNIVERSITY HOSPITAL
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9th European Congress on Menopause and Andropause / Maturitas 71, Supplement 1 (2012) S1–S82
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PREMATURE OVARIAN FAILURE AND TESTOSTERONE
THE SURVEY ON KOREAN MENOPAUSAL WOMEN’S BEHAVIOR AND PERCEPTION OF HORMONE THERAPY
M. Ivanisevic 1 , M. Barac 2 , A. Stefanovic 1 , S. Kadija 1 , K. Jeremic 1 , S. Vujovic 2 . 1 Gynecology and Obstetrics, Clinical Center of Serbia, Institute of Obstetrics and Gynecology, Faculty of Medicine, University of Belgrade; 2 Endocrinology, Clinical Center of Serbia, Institute of Endocrinology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Premature ovarian failure (POF) is a syndrome characterized by hypergonadotropic amenorrhoea and hypoestrogenism. The criteria for diagnosis are FSH over 40 IU/L and estradiol (E2 ) bellow 50 pmol/L in women younger than 40 years of age. Incidence of POF is 0.9-3% in women of reproductive age. POF, as the part of the pluriglandular insufficiency, can be confirmed by immunoendocrinology. Objective: Objective of this study was to compare testosterone levels in ethiologicaly different POF subgroups. Method: The study was conducted on 710 patients of average age 40.57±7.56 years, amenorrhoic period was 8.15±6.48 years. BMI 23.00±1.8kg/m2 . Group 1: 193 (27. 2%) POF with autoantibodies, accompanied by other autoimmune endocrinopathies. Group 2: 132 (18.5%) bilateral adnexectomy (arteficial POF). Group 3: 385 (54.3%) idiopathic POF. Blood samples were taken at 8 am for: FSH, LH, Prolactin, estradiol, testosterone, SHBG. Hormon analysis: RIA. Statistic:T test. Results: Significant difference was found in testosterone levels between groups (0.71±0.15 nM/L vs. 1.15±0.10 nM/L vs. 1.43±0.25nM/L) (p<0,05). The lowest level was in the first group and the highest level was in the third group. Conclusion: These data reveal the decrease in androgen synthesis in POF patiens with autoantibodies and associated autoimmune diseases. Higher testosterone levels in adnexectomy group, compared to autoantibodies group, can imply on the defects of adrenal steroidogenesis. As mechanism of the lowest testosterone in the first group is not fully understood and yet known, genetic and environmental factors might be involved in the stimuli inducing the immune response.
60 THE EFFECTS OF HORMONE REPLACEMENT THERAPY DEPENDING ON THE TYPE OF HORMONAL AGENTS J.-H. Kim 1 , Y.-J. Chung 1 , J. Namkung 1 , Y.O. Lew 2 , M.R. Kim 1 , H.H. Jo 1 . 1 Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul; 2 St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea Objectives: To assess the effects of hormone replacement therapy in postmenopausal women, depending on the type of hormonal agents. Methods: We reviewed the charts of 199 postmenopausal women who had received care at our hospital between January 1994 and December 2008. The patients were divided into the three groups: group 1 received combined estrogen and progesterone therapy (n=91); group 2 received estrogen only (n=65); and group 3 received tibolone (n=43). We compared the changes in biochemical markers of bone turnover, lipid profiles, and BMD during therapy. Results: BMD of the lumbar spine increased in groups 1 and 3 and BMD of total femur increased in groups 1 and 2 from the initial values after 3 years. However, BMD of the femoral neck and total femur decreased significantly in group 3 3 years after treatment initiation. Serum bone turnover markers decreased in all groups 1 year after treatment. In groups 1 and 3, the total cholesterol level decreased and the triglycerides level increased. However, there were no definite changes in the total cholesterol and triglycerides levels in group 2. The HDL-cholesterol level increased in groups 1 and 2, but decreased in group 3. As a result, BMD of the lumbar spine increased and total cholesterol level decreased in the combined therapy and tibolone groups. Tibolone had no beneficial effect on BMD of the femoral neck. Conclusion: Our results suggest that each therapy has different effects on BMD, biochemical markers of bone metabolism, and lipid profiles.
J.-H. Kim 1 , M.-R. Kim 2 . 1 Ob/Gyn, Chungwha Women’s Hospital; 2 Ob/Gyn, The Catholic University of Korea, Seoul, Republic of Korea Objective: The survey was conducted to investigate Korean menopausal women’s perception of hormone therapy and behavior when they are treated by hormone therapy. Method: During 4 weeks from September 2009 to October 2009, total 600 women aged 45-64 participated in the survey by phone contact. Out of answering women, women who have visited clinic/hospital at least 1 time to treat their menopausal symptom during last 1 year were included. Result: 80% women who have visited clinic/hospital to treat menopausal symptom, visited OBGY. Only 17% of these women were current user, and other 83% of these women had no experience of hormone therapy (63%) or stopped therapy (37%). Among women who had no experience of hormone therapy, the most common reason of not to take hormone therapy was concern of side effects (51%). And 67% of women who had concern of side effects worried about cancer incidence. But 60%-70% of women had misconception of cancer incidence. 60% of women disagreed that HRT will not increase overall cancer incidence, and 70% of women disagreed that HRT can prevent colorectal cancer. Conclusion: Many women with menopausal symptom do not take hormone therapy even though it is the most effective therapy. Most of women who take hormone therapy stop treatment within 2 years. Most common reason of not to take hormone therapy is concern about side effect, increasing incidence of cancer related to hormone therapy. But most women were revealed that they have misconception about cancer incidence.
62 A HORMONAL THERAPY COMPLIANCE SURVEY AT A UNIVERSITY HOSPITAL T.-H. Kim 1 , H.-H. Lee 1 , S.-H. Chung 1 , W.S. Lee 1 , E.S. Lee 2 . 1 Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon si; 2 Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea Objective: To verify compliance with hormonal therapy (HT) in a population of gynecologic outpatients in Gyeonggi Province Korea. Material and methods: During 2010, 24,694 women were seen in the gynecologic outpatient clinic of our university hospital, and 2,351 patients participated in the survey. The questionnaire was composed of basic characteristics and 14 items. Results: Mean age was 48±4.6 years, and 1586 women (67.5%) were postmenopausal and had stopped menstruation for a mean of 5.7±6.3 years. Mean body mass index was 22.393±4.446 kg/m2 . Only 755 women were taking HT and 1114 women were not taking HT. In total, 176 (7.5%) stated that HT is most effective for alleviating menopausal symptoms and 1579 (67.2%) stated that HT was safe. A total of 1425 (60.6%) respondents answered that there is a reason for taking HT and 1036 (44.0%) stated that HT was effective for sexual life and quality of life. Conclusions: Respondents thought that HT was most effective for menopausal symptoms, but few knew that HT is effective for osteoporosis and cardiovascular disease. It is important to educate women about HT to change social attitude.
63 ALTERNATIVE TREATMENT FOR MENOPAUSAL SYMPTOMS: EFFICACY AND SAFETY IN GREEK POSTMENOPAUSAL WOMEN G. Labos 1 , E. Trakakis 2 , I. Lambrinoudaki 3 . 1 3rd and 2nd Department of Obstetrics and Gynaecology, University of Athens; 2 Athens University Medical School; 3 2nd Department of Obstetrics and Gynaeocology, University of Athens, Athens, Greece Background: Approximately 75% of postmenopausal women have vasomotor symptoms. Menopause, furthermore, accelerates bone loss. Estrogen Progesterone Therapy (EPT) is a classical treatment for climacteric syndrome, but contraindications have limited its use.
9th European Congress on Menopause and Andropause / Maturitas 71, Supplement 1 (2012) S1–S82
59
61
PREMATURE OVARIAN FAILURE AND TESTOSTERONE
THE SURVEY ON KOREAN MENOPAUSAL WOMEN’S BEHAVIOR AND PERCEPTION OF HORMONE THERAPY
M. Ivanisevic 1 , M. Barac 2 , A. Stefanovic 1 , S. Kadija 1 , K. Jeremic 1 , S. Vujovic 2 . 1 Gynecology and Obstetrics, Clinical Center of Serbia, Institute of Obstetrics and Gynecology, Faculty of Medicine, University of Belgrade; 2 Endocrinology, Clinical Center of Serbia, Institute of Endocrinology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Premature ovarian failure (POF) is a syndrome characterized by hypergonadotropic amenorrhoea and hypoestrogenism. The criteria for diagnosis are FSH over 40 IU/L and estradiol (E2 ) bellow 50 pmol/L in women younger than 40 years of age. Incidence of POF is 0.9-3% in women of reproductive age. POF, as the part of the pluriglandular insufficiency, can be confirmed by immunoendocrinology. Objective: Objective of this study was to compare testosterone levels in ethiologicaly different POF subgroups. Method: The study was conducted on 710 patients of average age 40.57±7.56 years, amenorrhoic period was 8.15±6.48 years. BMI 23.00±1.8kg/m2 . Group 1: 193 (27. 2%) POF with autoantibodies, accompanied by other autoimmune endocrinopathies. Group 2: 132 (18.5%) bilateral adnexectomy (arteficial POF). Group 3: 385 (54.3%) idiopathic POF. Blood samples were taken at 8 am for: FSH, LH, Prolactin, estradiol, testosterone, SHBG. Hormon analysis: RIA. Statistic:T test. Results: Significant difference was found in testosterone levels between groups (0.71±0.15 nM/L vs. 1.15±0.10 nM/L vs. 1.43±0.25nM/L) (p<0,05). The lowest level was in the first group and the highest level was in the third group. Conclusion: These data reveal the decrease in androgen synthesis in POF patiens with autoantibodies and associated autoimmune diseases. Higher testosterone levels in adnexectomy group, compared to autoantibodies group, can imply on the defects of adrenal steroidogenesis. As mechanism of the lowest testosterone in the first group is not fully understood and yet known, genetic and environmental factors might be involved in the stimuli inducing the immune response.
60 THE EFFECTS OF HORMONE REPLACEMENT THERAPY DEPENDING ON THE TYPE OF HORMONAL AGENTS J.-H. Kim 1 , Y.-J. Chung 1 , J. Namkung 1 , Y.O. Lew 2 , M.R. Kim 1 , H.H. Jo 1 . 1 Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul; 2 St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea Objectives: To assess the effects of hormone replacement therapy in postmenopausal women, depending on the type of hormonal agents. Methods: We reviewed the charts of 199 postmenopausal women who had received care at our hospital between January 1994 and December 2008. The patients were divided into the three groups: group 1 received combined estrogen and progesterone therapy (n=91); group 2 received estrogen only (n=65); and group 3 received tibolone (n=43). We compared the changes in biochemical markers of bone turnover, lipid profiles, and BMD during therapy. Results: BMD of the lumbar spine increased in groups 1 and 3 and BMD of total femur increased in groups 1 and 2 from the initial values after 3 years. However, BMD of the femoral neck and total femur decreased significantly in group 3 3 years after treatment initiation. Serum bone turnover markers decreased in all groups 1 year after treatment. In groups 1 and 3, the total cholesterol level decreased and the triglycerides level increased. However, there were no definite changes in the total cholesterol and triglycerides levels in group 2. The HDL-cholesterol level increased in groups 1 and 2, but decreased in group 3. As a result, BMD of the lumbar spine increased and total cholesterol level decreased in the combined therapy and tibolone groups. Tibolone had no beneficial effect on BMD of the femoral neck. Conclusion: Our results suggest that each therapy has different effects on BMD, biochemical markers of bone metabolism, and lipid profiles.
J.-H. Kim 1 , M.-R. Kim 2 . 1 Ob/Gyn, Chungwha Women’s Hospital; 2 Ob/Gyn, The Catholic University of Korea, Seoul, Republic of Korea Objective: The survey was conducted to investigate Korean menopausal women’s perception of hormone therapy and behavior when they are treated by hormone therapy. Method: During 4 weeks from September 2009 to October 2009, total 600 women aged 45-64 participated in the survey by phone contact. Out of answering women, women who have visited clinic/hospital at least 1 time to treat their menopausal symptom during last 1 year were included. Result: 80% women who have visited clinic/hospital to treat menopausal symptom, visited OBGY. Only 17% of these women were current user, and other 83% of these women had no experience of hormone therapy (63%) or stopped therapy (37%). Among women who had no experience of hormone therapy, the most common reason of not to take hormone therapy was concern of side effects (51%). And 67% of women who had concern of side effects worried about cancer incidence. But 60%-70% of women had misconception of cancer incidence. 60% of women disagreed that HRT will not increase overall cancer incidence, and 70% of women disagreed that HRT can prevent colorectal cancer. Conclusion: Many women with menopausal symptom do not take hormone therapy even though it is the most effective therapy. Most of women who take hormone therapy stop treatment within 2 years. Most common reason of not to take hormone therapy is concern about side effect, increasing incidence of cancer related to hormone therapy. But most women were revealed that they have misconception about cancer incidence.
62 A HORMONAL THERAPY COMPLIANCE SURVEY AT A UNIVERSITY HOSPITAL T.-H. Kim 1 , H.-H. Lee 1 , S.-H. Chung 1 , W.S. Lee 1 , E.S. Lee 2 . 1 Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon si; 2 Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea Objective: To verify compliance with hormonal therapy (HT) in a population of gynecologic outpatients in Gyeonggi Province Korea. Material and methods: During 2010, 24,694 women were seen in the gynecologic outpatient clinic of our university hospital, and 2,351 patients participated in the survey. The questionnaire was composed of basic characteristics and 14 items. Results: Mean age was 48±4.6 years, and 1586 women (67.5%) were postmenopausal and had stopped menstruation for a mean of 5.7±6.3 years. Mean body mass index was 22.393±4.446 kg/m2 . Only 755 women were taking HT and 1114 women were not taking HT. In total, 176 (7.5%) stated that HT is most effective for alleviating menopausal symptoms and 1579 (67.2%) stated that HT was safe. A total of 1425 (60.6%) respondents answered that there is a reason for taking HT and 1036 (44.0%) stated that HT was effective for sexual life and quality of life. Conclusions: Respondents thought that HT was most effective for menopausal symptoms, but few knew that HT is effective for osteoporosis and cardiovascular disease. It is important to educate women about HT to change social attitude.
63 ALTERNATIVE TREATMENT FOR MENOPAUSAL SYMPTOMS: EFFICACY AND SAFETY IN GREEK POSTMENOPAUSAL WOMEN G. Labos 1 , E. Trakakis 2 , I. Lambrinoudaki 3 . 1 3rd and 2nd Department of Obstetrics and Gynaecology, University of Athens; 2 Athens University Medical School; 3 2nd Department of Obstetrics and Gynaeocology, University of Athens, Athens, Greece Background: Approximately 75% of postmenopausal women have vasomotor symptoms. Menopause, furthermore, accelerates bone loss. Estrogen Progesterone Therapy (EPT) is a classical treatment for climacteric syndrome, but contraindications have limited its use.