• Clinical and Experimental Reproductive Medicine
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• v.29 no.4
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• pp.279-285
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• 2002

Objective : To evaluate the difference between estrogen only therapy and estrogen-androgen combination therapy in surgical menopause patients. Materials and Method: Surgical menopause patients received 0.625 mg conjugated equine estrogens or 0.625 mg conjugated equine estrogens plus 1.25 mg methyltestosterone for 2 years. Bone mineral density, menopausal symptoms, lipoprotein profiles were measured. Results: Both groups showed increased bone mineral density. In the combination group, total cholestero l, high density lipoprotein cholesterol and triglycerides decreased. In the estrogen only group, low density lipoprotein cholesterol decreased but high density lipoprotein cholesterol increased significantly. In both groups, menopausal symptoms were much improved. Side effects were easily tolerated in both groups. Conclusions: Estrogen-androgen combination therapy had comparable benefits compared with estrogen only therapy.

• The Journal of Korean Obstetrics and Gynecology
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• v.24 no.4
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• pp.150-162
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• 2011

Purpose: To investigate the change of the climacteric syndrome with women with induced menopause by hysterectomy or ovariectomy compared with women with natural menopause. Methods: Menopausal women(aged 45-55) were selected at two oriental medicine hospitals, Sam-se Oriental Medicine Hospital and Daegu Hannny Oriental Medicine Hospital. They were asked about Kupperman's Index, MENQOL and a few additional questions. They were divided into two groups: women with induced menopause by hysterectomy or ovariectomy and women with natural menopause. To analyse the Kupperman's index and MENQOL, SPSS for Windows 12.0 and Wilcoxon Ranked Sum Test were used. Results: The total sums of Kupperman's index and MENQOL were significantly correlated with women with induced menopause and women with natural menopause and women with induced menopause had higher total sums. Both the renal and urinary tract disorder and the sexual disorder were significantly correlated with women with induced menopause and women with natural menopause. The gastrointestinal and psychosocial disorder of Kupperman's index and MENQOL were not significantly correlated with women with induced menopause and women with natural menopause. Conclusions: Women with induced menopause by hysterectomy or ovariectomy experienced climacteric syndrome more severely compared with women with natural menopause, specifically the renal and urinary tract disorder and sexual disorder.

• Journal of Menopausal Medicine
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• v.24 no.3
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• pp.155-162
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• 2018

Pelvic organ prolapse (POP) is bulging of one or more of the pelvic organs into the vagina and triggered by multiple causes. It is a very common disorder, especially among older women. POP is characterized by protrusion of the presentation part visible by the naked eye, and problems with urination or bowel movements. POP can be diagnosed based on the onset of symptoms and a pelvic exam, and management options include medical and surgical treatment. Although medical treatment cannot correct the abnormal herniation of the pelvic structures, this can help alleviate symptoms. One of the disadvantages of surgical interventions is recurrence, and advances in surgical techniques have decreased recurrence rates of POP. Therefore, author will explain the gynecology and urology approach and treatment.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.124-127
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• 2008

Leiomyomas are common in the myometrial layer of the uterus, though they are rarely found in other reproductive organs. Leiomyomas are benign, hormone-sensitive smooth muscle tumors. They develop during the reproductive years and regress after menopause. Preoperative diagnosis is difficult to make. We present a case of a 54-year-old woman with a vaginal wall tumor. The management in this case included surgical excision. Histologic examination definitively confirmed the diagnosis of a vaginal leiomyoma. We report the details of this case along with a brief review of the literature.

• Women's Health Nursing
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• v.18 no.4
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• pp.237-247
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• 2012

Purpose: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. Methods: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX$^{(R)}$ to calculate 10-year probability of major osteoporotic and hip fracture. Results: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. Conclusion: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.551-555
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• 2012

Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a $9{\times}6$ cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather than extensively to prevent incisional hernia considering the benign nature of the tumor and the low possibility of recurrence because the patient's age was near menopause, along with simultaneous bilateral salpingo-oophorectomy that was performed in this case. On reconstruction, mini-abdominoplasty was adopted to avoid possible wound complications and cosmetic deformities. The patient was satisfied with the cosmetic results, and neither recurrence nor functional problems occurred during the 1-year follow-up period. Plastic surgeons should keep in mind the possibility of cutaneous endometriosis in an abdominal mass of a female of reproductive age with a previous history of pelvic or intra-abdominal surgery. An optimal result from oncological, functional, and cosmetic standpoints can be achieved with conservative excision followed by mini-abdominoplasty of extensive Cesarean scar endometriosis.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.387-393
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• 2016

Background: CYP1A1 is a candidate gene for low-penetrance breast cancer susceptibility, as it plays an important role in the metabolism of carcinogens and estrogens. Purpose: The objective of this study was to assess the association between M2 (A2455G, Ile462Val) and M4 (C2453A, Thr461Asn) polymorphisms in CYP1A1 and breast cancer risk among Jordanian women and in subgroups stratified by menopausal status and smoking history. Materials and Methods: Blood samples were collected from 112 breast cancer female patients and 115 age-matched controls who underwent breast cancer screening with imaging and showed negative results (BI-RADS I or BI-RADS II). Genotyping was performed using the PCR-RFLP technique. Results: No statistically significant overall association was found between breast cancer risk and CYP1A1 M2 genotypes (p= 0.55; OR = 0.77; 95% CI= 0.32 - 1.83) nor with the M4 polymorphism (p= 0.95; OR= 0.95; 95% CI= 0.51 - 1.88). Analysis of subgroups defined by menopausal status or smoking history also revealed no association with these polymorphisms. Furthermore, the four identified haplotypes (AC; AA; GC and GA) were equally distributed among cases and controls, and haplotype analysis showed a strong linkage disequilibrium of both studied loci in either cases or controls (D'=1). Conclusions: Based on the study results, CYP1A1 M2 and M4 polymorphisms do not seem to play a major role in breast cancer risk among Jordanian females.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7467-7472
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• 2015

Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7485-7489
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• 2015

Background: Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. Materials and Methods: We conducted a cross-sectional study among women aged 18 to 25 using a self-administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Results: Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. Conclusions: The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.