Menopause is a natural part of the aging process that every woman experiences at some point in life. Menopausal symptoms have a negative impact on the quality of life. Common menopausal symptoms include vasomotor symptoms, mood swings, concentration issues, vaginal dryness, atrophy of secondary sexual traits, libido loss, musculoskeletal discomfort, osteopenia, and osteoporosis. The most effective treatment for the relief of menopausal symptoms is estrogen, with or without. Hormone replacement therapy (HRT) is most beneficial before 60 years of age or within 10 years of menopause. Other menopause-related symptoms including mood swings, sleep disturbance, sexual dysfunction, and myalgia may improve with HRT. HRT is also effective in preventing bone loss associated with menopause and in reducing the incidence of all osteoporosis-related fractures, including those of the vertebrae and hip.

Background
: There have been bone mass studies for the treatment of osteoporosis, nonetheless, little attention has been paid to the management of osteopenia. This study was to evaluate the effects of estrogen, alendronate and their combination on bone mineral density and bone metabolism in the postmenopausal women with osteopenia.

Methods : A total of 150 healthy regional patients with osteopenia from Busan were enrolled in prospective randomized clinical trial and randomly assigned to receive conjugated equine estrogen (group I), alendronate (group II), or combination of the two (group III). Assessments included BMD of L2-4 spines and femur neck by DEXA and markers of bone turnover including serum osteocalcin, total alkaline phosphatase and urine Deoxypyridnoline (Dpd). BMD and markers of bone turnover were re-evaluated at 6 and 12 months after the treatment.

Results : BMD of the lumbar spines increased significantly at 12 months after treatment in the three groups (P＜0.05). BMD of the femur neck increased at 12 months after treatment in the three groups, but significantly in group III (P＜0.05). Serum osteocalcin decreased at 12 months after treatment in the three groups, but only significantly in group III. Urine Dpd decreased at 12 months after treatment in three groups, but significantly in group, II and III (P＜0.05). Serum total alkaline phosphatase decreased at 12 months after treatment in only group III (P＜0.05). There was more favorable benefit for group III in BMD of the lumbar spines and serum osteocalcin and urine Dpd at 12 months after treatment compared to group, II and III (P＜0.05).

Conclusion : These results indicated a favorable benefit of conjugated equine estrogen, alendronate, or combination of the two in BMD and important markers of bone turnover. The combined treatment with conjugated equine estrogen and alendronate was more effective in postmenopausal women with osteopenia. Long-term studies are required to confirm these results.

Background
: Platelet activation has been implicated in the pathogenesis of a number of diseases, which include atherosclerosis, coronary vascular disease, and cerebrovascular disease. There have been controversies with the influence of hormone therapy on platelet activation. The purpose of this study was to define the effect of long-term hormone therapy on platelet activation.

Methods : We recruited a total of 162 postmenopausal women aged 55 and above among wihch eighty healthy postmenopausal women had received hormone therapy for more than 5 years and the remaining eighty- two healthy postmenopausal women with no hormone therapyapy. Baseline characteristics as well as the parameters related to platelet activation were compared between the two groups using T-test. After platelet activation was defined by the reference range, multivariated logistic regression analysis was performed determining the odds ratio of hormone therapy on platelet activation.

Results : The MPC and PCDW were significantly lower in the HT group than the Non-HT group (P＜0.001), which suggests that platelets were more activated in the HT group more than in the non-HT group. Multiple logistic regression analysis showed that the odds ratio of the possibility of platelet activation in HT group was 19 times (P＜0.001).

Conclusion : Long term hormone therapy increased platelet activation significantly, which may be a contributing factor of thromboembolism.

Background
: Bone mass changes in men is related to age, BMI, sex hormones and other factors. In prior studies, bone markers were negatively correlated with bone mineral density, free testosterone, and estrogen and was positively correlated with SHBG. In a study of sex hormones and bone markers in Korean men estradiol was negatively correlated with deoxypyridinoline. In this study, the relationship of testosterone, estradiol, calculated free testosterone, FEI and SHBG to bone turnover markers in adult men were investigated.

Methods : This was a cross-sectional study of 184 men who had undertaken a health screening program in one general hospital in Bundang from November, 2001 to February, 2003. We surveyed information concerning the past medical history, current medication, alcohol consumption amount per week and smoking amount by means of self questionnaire records. Serum total testosterone, estradiol, SHBG and osteocalcin, alkaline phosphatase were measured at a fasting state. Urine was tested for deoxypyridinoline. Free testosterone was calculated using albumin, SHBG, and total testosterone level.

Results : Deoxypyridinoline adjusted by age, BMI was negatively correlated with FEI (r=-0.17, P=0.020) and was positively correlated with smoking amount (r=0.20 P= 0.007). Osteocalcin was negatively correlated with calculated free testosterone and ethanol consumption amount (r=-0.186, P=.0.12, r=-0.186, P=0.012). Multiple regression analysis showed that the most powerful factor influencing deoxypyridinoline was smoking amount (R²= 0.046), followed by FEI, BMI, and the one influencing osteocalcin was BMI (R²=0.050), ethanol amount and calculated free testosterone. After adjusting for age, BMI, drinking amount and smoking amount FEI shown to be a predictor of deoxypyridinoline (β=-0.08, p＜0.01, R²=0.101). After adjusting for age, BMI, and drinking amount calculated free testosterone was shown to be a predictor of osteocalcin (β=-0.570, P＜0.01, R²=0.130) in multiple regression model.

Conclusion : In adult men, FEI shown to be a predictor of deoxypyridinoline and calculated free testosterone to be a predictor of osteocalcin as an independent variable.