한국 폐경 여성의 조기/이른 폐경 시기에 따른 삶의 질의 차이

소은선 인문사회 21 2022 인문사회 21 Vol.13 No.1

The Differences of Quality of Life According to Premature/EarlyMenopausal Timing Among Korean Menopausal WomenEunsun So Abstract: This study was conducted to identify the differences of Quality Of Life (QOL) according to menopausal timing of premature/early/normal menopause among Korean menopausal women. This study utilized the 2014-2019 Korea National Health Nutrition Survey data with the total of 4,266 women aged 20-65 years who answered “have presnetly menopaused” and it’s age of menopause, These subjects were grouped those who menopaused -39, 40-44, and 45-54 years old into premature, early, and normal menopause, and to analyze the differences of QOL according to these groups, used complex sample logistic regression analysis. As a result, the premature, early, and normal menopause of the study subjects comprised 1.2%, 5.0%, and 93.8% respectively. Statistical differences of QOL according to menopausal timing were not shown. However, statistical differences of QOL according to a period after menopause were shown; whereas QOL of -5 years after menopause were not significantly different from the comparison with 16- years after menopuase, QOLs of 6-10 years and 11-15 years after menopause showed significantly better (β=0.02, 0.03, p=.048, .005 respectively). Intervention is necessary focusing on the period after menopause rather than menopausal timing to improve QOL among menopausal women. Key Words: Quality Of Life, Premature Menopause, Postmenopause, Korea, Women 한국 폐경 여성의 조기/이른 폐경 시기에 따른 삶의 질의 차이소 은 선** 요약: 본 연구는 한국 폐경 여성의 조기/이른/정상 폐경인 폐경시기에 따른 삶의 질의 차이를 규명하고자 시행되었다. 본 연구는 2014-2019년 국민건강영양조사 자료를 활용하여 현재 자연폐경이면서 폐경 연령에 응답한 20~65세 여성 중 폐경 연령이 54세 이전에 온 총 4,266명을 대상으로 하였다. 또한, 이들 대상자들의 폐경 연령에 따라 -39, 40-44, 45-54세에 폐경한 조기폐경, 이른 폐경, 정상 폐경으로 군을 구분하였고, 이들 군별 삶의 질과의 차이를 분석하는데 복합표본 선형 회귀분석을 사용하였다. 연구결과, 연구대상자는 자연폐경 시기에 따라 조기 폐경, 이른 폐경, 정상 폐경이 각각 1.2%, 5.0%, 93.8%였다. 폐경 시기에 따라 삶의 질은 유의한 차이를 보이지 않았다. 폐경 후 시기에 따라 삶의 질에 유의한 차이를 보였는데, 폐경 후 16년 이상이 경과한 군과 비교하여 폐경 후 5년 이내에서는 유의한 차이가 없었던 반면, 폐경 후 6-10년, 11-15년에는 유의하게 삶의 질이 나아졌다(각각 β=0.02, 0.03, p=.048, .005). 폐경 여성의 삶의 질을 향상하기 위해서는 폐경 시점 보다는 폐경 후 시기에 따른 중재가 요구된다. 핵심어: 삶의 질, 조기 폐경, 폐경후, 한국, 여성 □ 접수일: 2022년 2월 7일, 수정일: 2022년 2월 14일, 게재확정일: 2022년 2월 20일* 이 논문은 2021년도 전북대학교 연구기반 조성비 지원에 의하여 연구되었음. ** 전북대학교 간호학과 교수(Professor, Jeonbuk National Univ., Email: soeunjee@naver.com)

한국 성인여성의 조기 폐경과 이른 폐경 발생률 추세와 조기/이른 폐경 위험인자

소은선 한국산학기술학회 2024 한국산학기술학회논문지 Vol.25 No.2

This study was conducted using data extracted from the 4th to 8th National Health and Nutrition Examination Survey (2007~2021) and targeted 27,699 women aged 30 to 65 who responded to questions about current menstruation. Women who underwent artificial menopause were excluded. The analysis was performed using complex sample multiple logistic regression analysis and complex sample multivariate Cox proportional hazards regression analysis. The rates of early and early menopause among subjects who underwent natural menopause were 0.9 to 3.1% and 3.9 to 7.3%, respectively. These rates were lower in the 5th to 8th surveys than in the 4th survey; rates of early and early menopause decreased by 0.31 to 0.46-fold and 0.54 to 0.72-fold, respectively. Age (OR=1.01, 95% CI= 1.00-1.02), middle school graduation (OR=1.12, 95% CI= 1.00-1.25), and smoking (OR=1.18, 95% CI: 1.07-1.13) were associated with increased risk of premature/early menopause, and sales/service workers had a lower risk than unemployed individuals (e.g., housewives and students) (OR=0.91, 95% CI= 0.84-0.99). This study provides basic data for those developing policies or interventions aimed at delaying premature/early menopause.

Case Report : Autosomal Translocation Patient Who Experienced Premature Menopause: A Case Report

( Tae-hee Kim ),( Yesol Kim ),( Do-won Jeong ),( Eun-gyeong Lee ),( Dong-su Jeon ),( Jun-mo Kim3 ) 대한폐경학회 2015 대한폐경학회지 Vol.21 No.2

Premature ovarian failure (POF) is a condition in which the ovarian functions of hormone production and oocyte development become impaired before the typical age for menopause. POF and early menopause are present in a broad spectrum of gonad dysgenesis, from a complete cessation of ovarian function to an intermittent follicle maturation failure. Actually POF has been identified as a genetic entity (especially chromosome X), but data on genetic factors of premature menopause are limited. Until now, several cases revealed that inactivation of X chromosomes has an effect on ages of premature menopause and females with balanced or unbalanced X-autosome translocations can have several reproductive problems. On the other hand, there have been a few data that was caused by autosome-autosome translocation can lead. Therefore we report a relevant case of POF with translocation between chromosomes 1 and 4. She had her first menstrual period at the age of 12, and after 7 years she stopped menstruation. Chromosomal analysis showed 46, XX, t (1;4) (p22.3;q31.3). While evaluating this rare case, we could review various causes (especially genetic factors) of POF. To remind clinicians about this disease, we report a case of POF caused by autosomeautosome translocation with a literature review. (J Menopausal Med 2015;21:112-114)

조기폐경 여성의 골다공증과 골다공증성 골절

이동옥 대한골다공증학회 2012 Osteoporosis and Sarcopenia Vol.10 No.1

Premature menopause is well known risk factor for osteoporosis and fragility fracture. Although its definition is menopause before the age of 40, many studies about the risk of osteoporosis and fragility fracture use diverse definition for it as early menopause. This article is to review the data of the impact of premature or early menopause on bone density and fragility fractures.

Assessment of Menopausal Symptoms among Early and Late Menopausal Midlife Bangladeshi Women and Their Impact on the Quality of Life

( Kawsar Ahmed ),( Papia Jahan ),( Israt Nadia ),( Farzana Ahmed ),( Abdullah Al Emran ) 대한폐경학회 2016 대한폐경학회지 Vol.22 No.1

Objectives: Every physical abnormal criterion has an impact on the health. Late menopause causes different physiological problems which alike early menopause. The research interest is associated with both early and late menopausal women of Bangladesh as only few menopausal studies available in South East Asia especially in Bangladesh. The aims of this study are not only to assess the symptoms of menopausal abnormality but also to determine the impact of these symptoms on the quality of life (QOL) of the female society in Bangladesh. Methods: Data mining techniques are used to rank the 22 factors (conducted with questionnaire) commonly associated with menopause. Among the participants menstruation that stops before 45 years was considered as early menopausal status and after 50 years as late menopausal. The mean of age and mean length of time in years, since menopause for all participants were 61.55±10.7 and 14.13±11.17, respectively. Recorded data indicated 67% were early menopausal women and 33% were late menopausal women. Results: Results indicated that feeling tired or lacking in energy and dizziness (83%) and depression (82%) have worst impact on QOL among all factors, respectively. The next prevalent symptoms included hot flashes (64%), osteoporosis (72%), sweating at night (63%), concentration problem (75%), irritability (63%), feeling tense (77%), headache (66%). However, less frequent factors included breathing problems (33%), loss of feeling (31%), coherent heart disease (13%) and type2 diabetics (9%). Conclusion: Our study indicates that early menopausal women are facing more physiological problems than the late menopausal women on their QOL. (J Menopausal Med 2016;22:39-46)

조기 난소 부전

이지영 ( Ji Young Lee ),정혜원 ( Hye Won Chung ) 대한폐경학회 2009 대한폐경학회지 Vol.15 No.2

Premature ovarian failure is defined as amenorrhea, hypergonadotropinemia, and estrogen deficiency in women under the age of 40 years, with a prevalence of 1%. In the majority of cases, the underlying cause is not identified. The known causes include genetic aberrations, autoimmune ovarian damage, iatrogenic following surgery, radiotherapy or chemotherapy for malignancies, and environmental factors (viral infections and toxins). The diagnosis is based on the finding of amenorrhea before age 40 years associated with FSH levels in the menopausal range. There is a particularly urgent need to determine the optimum therapeutic hormonal regimens in women with POF, both in terms of immediate symptom relief and for protection against the long-term sequelae of early menopause.

The Incidence of Chemotherapy-induced Amenorrhea and Recovery in Young (<45-year-old) Breast Cancer Patients

김현아,Dong-Sun Shin,Nan-Mo Moon,백남선,노우철 한국유방암학회 2009 Journal of breast cancer Vol.12 No.1

Purpose: Although adjuvant chemotherapy improves the survival of premenopausal breast cancer patients, it could induce the premature menopause. The objective of this study was to investigate the incidence and risk factors of chemotherapy-induced amenorrhea (CIA) and recovery for young (< 45-year-old) breast cancer patients. Methods: We examined patients with primary invasive breast cancer who had been treated with surgery and adjuvant chemotherapy from January 2003 to June 2006. All of the patients were younger than 45 year and they had regular menstruation at the time of diagnosis. Amenorrhea was defined as the absence of menstruation for three consecutive months or a serum follicular stimulating hormone level > 30 mIU/mL. Results: A total of 324 patients were included in this study. Of these patients, 261 patients (80.6%) developed amenorrhea just after the completion of chemotherapy. During follow-up, 77 patients (29.5%) resumed menstruation. Amenorrhea rates at 6, 12, 24, and 36 months after chemotherapy were 72.2%, 66.6%, 58.1%, and 55.5%. Women who recovered from amenorrhea were significantly younger than the women who did not recover (p<0.001). Patients treated with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) less frequently recovered from amenorrhea than patients who were treated with anthracycline or taxane-based chemo- therapy (p<0.001). Conclusion: The age of the patient was the most important factor for the development of CIA. Patients treated with a CMF regimen and older patients showed poor recovery from CIA. These results could be helpful to make decisions about the treatment strategies for premenopausal young women.

재생 불량성 빈혈환자에서 동종 골수이식 후 난소기능 회복에 관한 연구

류순원(Sun Won Yoo),김미란(Mi Ran Kim),권동진(Dong Jin Kwon),정기욱(Gi Wook Chung),김장흡(Jang Heub Kim),임용택(Yong Taik Lim),김진홍(Jing Hong Kim),나종구(Jong Gu Rha) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.3

Objective: Ovarian failure is often common complication by the conditioning protocol used for bone marrow transplantation (BMT). To determine the frequency of recovery of ovarian function after allo-BMT and the major factor that predict recovery, we monitored ovarian function in 24 premenopausal women Method: Twenty-four women met the inclusion criteria, which were (1) moderate to severe aplastic anemia before BMT, (2) disease-free at least 18 month after transplantation, (3) age younger than 40 years and more than 3 years after menarche at transplantation and (4) regular menstrual periods before transplantation. Recovery of ovarian function was determined by regular menses without menopausal symptom and sign. we divided conditioning regimen to two groups, Group I : cytoxan alone(n=17), Group II : cytoxan plus total body irradiation (TBI)(n=7). Results: All women became amenorrhea after BMT and the clinical characteristics were not significant between two groups. 17 patients who received only cytoxan all recovered ovarian function between 1 to 14 months(median : 7.28) after BMT. The median age at BMT of women with regained ovarian function was 26 years (range, 21 to 33) versus 30 (range, 21 to 37) for those who did not. The age at transplantation was not significant between two groups in our study and the most predictive independent factor in ovarian recovery is the presence of total body irradiation. None of women who received TBI regained ovarian function during 19-49 month follow up. Conclusion: Gonadal insufficiency due to pre-BMT conditioning is more severe in radiation based regimen than cytoxan alone. therefore, we recommend early hormone replacement therapy in radiation treated women to prevent the complication of premature menopause.

Relationship between Early Menopause and Periodontal Disease in Korean Postmenopausal Women

이윤희,Sun-Mi Kim,안은숙 한국치위생과학회 2018 치위생과학회지 Vol.18 No.5

The purpose of this study was to evaluate the relationship between early menopause and periodontal disease in postmenopausal women using data from the 6th Korean National Health and Nutrition Examination Survey (2013∼2015). A study was conducted with 2,048 postmenopausal women aged 45 to 74 years. Participants were divided into the early menopause group (menopause occurring at age 45 years or before) and normal menopause group (menopause occurring after age 45 years). A community periodontal index greater than or equal to code 3 was used to define periodontal treatment needs. A chi-square test was used to confirm the bivariate relationship between the variables. Multinomial logistic regression analysis was used to adjust for covariates (age, education, family income, body mass index, alcohol drinking, smoking, visiting dentist in the last year, use of oral care products, frequency of tooth brushing per day). The risk of periodontal disease was higher in the early menopause group after adjusting for potential confounders (odds ratio, 1.59). In particular, the relationship between early menopause and periodontal disease was more evident in women with low education and those who did not use oral care products. The findings of this study suggest that early menopause is a significant factor of periodontal disease in Korean women.

조기폐경 여부에 따른 삶의 질 관련 요인: 국민건강영양조사 자료(2014-2017년) 분석

조옥희,황경혜 한국여성건강간호학회 2020 여성건강간호학회지 Vol.26 No.2

Purpose: The purpose of this study was to compare the health‐related quality of life of premature menopausal women with that of normal postmenopausal women and to identify factors related to quality of life in these two groups. Methods: A secondary analysis was conducted of a sample of 5,910 postmenopausal women drawn from women aged 19–79 years, using raw data from the Korea National Health and Nutrition Survey between 2014 and 2017. Quality of life was compared between premature menopausal women and normal postmenopausal women using the t‐test and chi‐square test, and factors related to quality of life were analyzed by multivariate logistic regression using SAS version 9.4. Results: There was no significant difference in quality of life between premature menopausal women and normal postmenopausal women. Subjective health status and symptoms of depression were identified as factors related to quality of life in women with premature menopause, while engaging in aerobic physical activity, subjective health status, stress, and symptoms of depression were found to be related to quality of life among normal postmenopausal women. Conclusion: It is necessary to support self‐care measures for both premature and normal menopausal women to adapt to changes caused by menopause, and multidimensional strategies should be developed considering postmenopausal women’s subjective health status and symptoms of depression to improve their quality of life.