Background
: Since the Women's Health Initiative (WHI) study indicated that the significant risks are associated with hormone replacement therapy (HRT), it has been highly expected that postmenopausal women have decisional conflict about HRT. We investigated how much decisional conflict women have in taking HRT and what factors were associated with this conflict.

Methods : A total of 312 postmenopausal women, who had been on HRT or just began, were surveyed from May 10 to June 27, 2005. The subjects were asked by questionnaire that included demographic characteristics and factors related to decisional conflict. Decisional conflict was assessed using the Decisional Conflict Scale (DCS) composed of 16 items.

Results : The mean score of DCS was 2.61, which was severe and lack of support from friends and relatives was the most common major conflicting factor. Forty-five percent of the participants started HRT by doctor's recommendation, but had a higher decisional conflict compared to those who started on their own or by encouragement from family and friends. Women who were exposed to mass-media or who had discontinued HRT previously had a lower conflict. Higher the educational level and longer the duration of HRT before stopping lowered decisional conflict. DCS was not significantly influenced by age, income, menopausal symptoms, duration of HRT and the history of hysterectomy.

Conclusion : Postmenopausal women when making a decision to begin HRT had high conflict. The factors related to conflict were educational level, exposure to mass-media, and motivation to begin therapy. Therefore, adequate and continued counseling with doctors may reduce women's decisional conflict about HRT.

Background
: Hormone replacement therapy (HRT) has been used as a effective therapeutic strategy of postmenopausal osteoporosis. However, the studies on HRT are insufficient, particularly in early postmenopausal women in Korea. This study was designed as a community based clinical trial and was conducted for 1 year.

Methods : One hundred and forty early postmenopausal women aged 49 to 54 years who resided in Ulsan in Korea were enrolled in this study. The osteoporosis prone life style and general characteristics of the participants and their measured BMD were investigated. The therapy groups included 45 women who were assigned to one of the following regimens in 28 day cycles for 1 year: (1) conjugate equine estrogen (CEE), 0.625 mg/d daily, medroxyprogesterone acetate (MPA) 2.5 mg/d daily and calcium 500 mg/d daily (2) CEE 0.625 mg/d daily, MPA 10 mg/d for days 1 through 12 and calcium 500 mg/d daily.

Results : The women in the therapy groups had an average gain of 5.4%, 4.2%, 2.1%, 4.9% in BMD in the lumbar spine, femur total, femur neck and ward's area, respectively. HRT has significantly influenced the BMD after controlling age, month since menopause, alcohol intake, smoking, calcium intake, exercise, body mass index and baseline BMD. The baseline BMD and the BMI were factors that influenced the effect of HRT in BMD.

Conclusion : HRT had positively influenced the BMD in Korean women. The baseline BMD and the BMI were predictors of the effect of HRT in BMD change.

Background
: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis.

Methods : The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value.

Results : The mean age and ages at menopause were 59.1(±6.2) and 50.7 (±2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis.

Conclusion : The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.

Background
: This study was performed to find out about the factors related to administration of hormone replacement therapy (HRT) in postmenopausal women.

Methods : One thousand seventy three postmenopausal women living in Busan and Kimhae were surveyed from August, 2000 to February, 2001. The subjects were asked whether they were receiving the HRT or not and about several factors that have known to be related to receiving the HRT.

Results : Among the total, 16.3% of women were current users, 12.4% were ex-users, and 71.2% were non-users. There were significant differences in age, marital status, number of children, education level, and income among the three groups. The proportions of hysterectomy and health-related behaviors were higher among current and ex-users than non-users. The current users were receiving the HRT by continuous combination method rather than cyclic therapy. Among them, 70% responded 'physician's recommendation' as the main reason for receiving the HRT. Among the current users 48% responded 'improved general condition' for receiving as the main reason the HRT currently. However, 29% of ex-users stopped therapy because of side effects. Among non-users 55% have not been provided with information about the HRT. Women having regular exercise at least once a week were 3.5 times more likely to be current users (95% C.I.: 1.3∼9.6). One year after menopause women were 1.2 times (95% C.I: 1.0∼1.4) more likely to be current users.

Conclusion : Postmenopausal women who exercised regularly and experienced menopause at an older age seemed to be more likely current users. Therefore, women having such characteristics may need more adequate information about the HRT.

Background
: Estrogen deficiency after menopause is a major reason of bone loss in postmenopausal women. YSM (years since menopause) is negatively related with BMD in postmenopausal women. Bone loss after menopause is accelerated in early stage of menopause, and then decreases. There are some evidence that body weight can prevent bone loss in menopausal women. Therefore, we evaluated associations of the general characteristics and lumbar BMD of postmenopausal Korean women, and determined the rate of bone loss after menopause at 5-year interval.

Methods : BMD was measured by DEXA system, and physical, anthropometric data including body fat were obtained in 1006 peri- and postmenopausal women. Pearsons correlation coefficients were made among physical, anthropometric data and lumbar BMD. To determine the contributable factors for lumbar Bmd, multiple regression analysis was done.

Results : 1) In Pearsons correlation analysis among body composition YSM and spinal BMD, YSM was strongly associated negatively with spinal BMD. 2) On the other hand, weight and BMI was associated positively with psinal BMD. 3) The percent difference in spinal BMD between perimenopause and 5-years after menopause was 15.3%. 4) Years since menopause, body weight was revealed as and important factor that predicted spinal BMD by multiple stepwise regression analysis.

Conclusion : We conclude that YSM and body weight were revealed as important factors that can predict spinal BMD in postmenopausal women.

Background
: As life span is increasing, so is interest about adult disease. Especially the number of postmenopausal women has increased, and postmenopausal symptoms have become an important problem causing low quality of life. Hormone replacement therapy was introduced to overcome these problems. Authors investigated to evaluate the effect hormone replacement therapy on the quality of life of postmenopausal women.

Methods : From April to June 1997, we surveyed 188 postmenopausal women(91 women were on hormone replacement therapy, and 97 women were in the controlled group in Sungnam Center Hospital) with COOP/WONCA chart Korean version.

Results : COOP/WONCA chart(Korean version) is composed of seven dimensions, among these four dimensions(change in health, overall health, daily activity and pain) were shown statistically significant difference between two groups. But three dimensions (social activity, physical fitness and feelings) were not shown to be statistically different. Total mean score of COOP/WONCA chart showed statistically significant difference.

Conclusion : To improve the quality of life of postmenopausal women, primary care physician should consider hormone replacement therapy along with proper patient selection and periodic follow up.