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

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.


The percentage change of use of total hormone, ET/EPT, tibolone after publication of WHI results in 2002 (21).ET = estrogen therapy, EPT = estrogen plus progesterone therapy, WHI = post-Women's Health Initiative.
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Figure 3: The percentage change of use of total hormone, ET/EPT, tibolone after publication of WHI results in 2002 (21).ET = estrogen therapy, EPT = estrogen plus progesterone therapy, WHI = post-Women's Health Initiative.

Mentions: Last, HRT usage was shown to have increasing trend in the latter 5-year group. Previous data (2021) described decreased number of HRT users in the post-Women's Health Initiative (WHI) era, however recently in Korea, the number seems to increase again with the rising number of tibolone users (Fig. 3). According to the Long-Term Intervention on Fractures with Tibolone (LIFT) study (22), invasive breast cancer risk was decreased by using tibolone. It was also shown to be as effective as EPT for postmenopausal symptoms but without causing as much PMB (202123), therefore eventually the number of tibolone users continued to increase. From this study population, the latter 5-year period included more number of tibolone users than the first half of the decade (23.6% vs. 18.8%), which also reflects this phenomenon. However, as described elsewhere in literature (23), EPT is still the most common HRT-related cause of PMB and this study population also comprises more of EPT users than tibolone. This also may be the reason that the prevalence of PMB associated with HRT seems to be stationary although the number of women using HRT was previously decreased.


Common Causes of Postmenopausal Bleeding in Korean Women: 10-Year Outcomes from a Single Medical Center
The percentage change of use of total hormone, ET/EPT, tibolone after publication of WHI results in 2002 (21).ET = estrogen therapy, EPT = estrogen plus progesterone therapy, WHI = post-Women's Health Initiative.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383617&req=5

Figure 3: The percentage change of use of total hormone, ET/EPT, tibolone after publication of WHI results in 2002 (21).ET = estrogen therapy, EPT = estrogen plus progesterone therapy, WHI = post-Women's Health Initiative.
Mentions: Last, HRT usage was shown to have increasing trend in the latter 5-year group. Previous data (2021) described decreased number of HRT users in the post-Women's Health Initiative (WHI) era, however recently in Korea, the number seems to increase again with the rising number of tibolone users (Fig. 3). According to the Long-Term Intervention on Fractures with Tibolone (LIFT) study (22), invasive breast cancer risk was decreased by using tibolone. It was also shown to be as effective as EPT for postmenopausal symptoms but without causing as much PMB (202123), therefore eventually the number of tibolone users continued to increase. From this study population, the latter 5-year period included more number of tibolone users than the first half of the decade (23.6% vs. 18.8%), which also reflects this phenomenon. However, as described elsewhere in literature (23), EPT is still the most common HRT-related cause of PMB and this study population also comprises more of EPT users than tibolone. This also may be the reason that the prevalence of PMB associated with HRT seems to be stationary although the number of women using HRT was previously decreased.

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.