Understanding the effects of sex and sex differences on liver health and disease is crucial for individualized healthcare and informed decision-making for patients with liver disease. The impact of sex on liver disease varies according to its etiology. Women have a lower prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) than men. However, postmenopausal women face a higher risk of advanced liver fibrosis due to hormonal influences. Sex differences affect the pathogenesis of MASLD, which involves a complex process involving several factors such as hormones, obesity, and the gut microbiome. Furthermore, sex-related differences in the development of MASLDrelated hepatocellular carcinoma have been observed. The sex-specific characteristics of MASLD necessitate an individualized management approach based on scientific evidence. However, research in this area has been lacking. This article reviews the current understanding of sex differences in MASLD.
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The evaluation of menopausal status is an important subject in the field of treatment of hormone receptor positive breast cancer. According to the menopausal status, endocrine therapy should be categorized by individual patient. However, the gonadal injury caused by various therapeutic drugs and its recovery would confuse the interpretation of clinical and biological markers for ovarian reserve. There are some methods to examine the functional ovarian reserve indirectly. Ultrasonography for counting follicles is a relatively reliable procedure, although it is not feasible because of time-labor consumption and high cost. Biological marker from blood samples such as serum follicle stimulating hormone (FSH), serum estradiol (E2), serum inhibin, or anti-Müllerian hormone (AMH) would be a better choice. The examination of serum FSH and E2 is already recommended as biomarkers for measuring functional ovarian reserve in many guidelines. However, there are limitation of serum FSH and E2 in patients with chemotherapy-induced amenorrhea and treated by tamoxifen. AMH is promising biomarker in the field of infertility treatment even in the patients treated by chemotherapy. It might be a possible biomarker to determine the menopausal status for decision-making whether aromatase inhibitor could be applicable or not in hormone positive breast cancer patients with chemotherapy induced amenorrhea or treated by tamoxifen.
This study was performed to find out obstetricians-gynecologists' view on taking hormone replacement therapy HRT to perimenopausal women in Korea.
Questionnaires were mailed to 300 Korean obstetricians-gynecologists in order to obtain their views on the use of hormone replacement therapy. A total of 136 gynecologists responded.
Most of obstetricians-gynecologists(88.2%) were prescrinbing HRT to the perimenopausal or postmenopausal women. The most common indication of HRT was the treatment of vasomotor symptoms(56.6%) in symptomatic postmenopausal women and the prevention of osteoporosis(46.6%) in asymptomatic postmenopausal women. The most common routes of HRT were the oral(66.3%) administration. About two third of respondents prescribed HRT by cyclic estrogen-progestogen combined therapy(47.4%), and 46.8% of respondents thought that HRT must be started within 5 years after menopause. The duration of HRT was variable and 23.5-36.9% of respondents thought that HRT should be continued through the life.
This survey suggests that the most of Korean obstetricians-gynecologists favors the use of HRT in postmenopausal women but the results may become generalisable to the wider population as information on the potential benefits of hormone replacement therapy is disseminated.
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