Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study

Objective To analyze the relationship between pelvic organ prolapse (POP) and menopausal hormone therapy (MHT). Methods This retrospective cohort study used Korean National Health checkup and insurance data from 2002 to 2019. Women who used MHT for more than 6 months between 2002 and 2011 were inclu...

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Main Authors: Hee-Yeong Jung, Tae-Ran Kim, Gwan Hee Han, Jin-Sung Yuk
Format: Article
Language:English
Published: Korean Society of Obstetrics and Gynecology 2025-05-01
Series:Obstetrics & Gynecology Science
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Online Access:http://www.ogscience.org/upload/pdf/ogs-24071.pdf
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author Hee-Yeong Jung
Tae-Ran Kim
Gwan Hee Han
Jin-Sung Yuk
author_facet Hee-Yeong Jung
Tae-Ran Kim
Gwan Hee Han
Jin-Sung Yuk
author_sort Hee-Yeong Jung
collection DOAJ
description Objective To analyze the relationship between pelvic organ prolapse (POP) and menopausal hormone therapy (MHT). Methods This retrospective cohort study used Korean National Health checkup and insurance data from 2002 to 2019. Women who used MHT for more than 6 months between 2002 and 2011 were included in the MHT group; postmenopausal women with no MHT use comprised the non-MHT group. Results In the non-MHT group, there were 1,001,350 women, while the MHT group had 353,206 women. Tibolone (adjusted hazard ratio [aHR], 0.87; 99% confidence interval [CI], 0.818-0.926) and combined estrogen plus progestin by the manufacturer (CEPM) (aHR, 0.821; 99% CI, 0.758-0.89) were associated with reduced POP risk. The other oral MHT groups and the transdermal estrogen group showed no significant difference in POP risk compared with the non-MHT group (other oral MHT: aHR, 1.045; 99% CI, 0.941-1.161) (transdermal estrogen: aHR, 1.252; 99% CI, 0.731-2.145). Lower body mass index (BMI) (<18.5) was associated with reduced POP risk (aHR, 0.822; 99% CI, 0.698-0.968), while a BMI between 23 and 29.9 was associated with increased risk (BMI 23-24.9: aHR, 1.143; 99% CI, 1.088-1.2) (BMI 25-29.9: aHR, 1.173; 99% CI, 1.12-1.228). All parities had a higher POP risk than parity 1 (parity 0 or no response: aHR, 1.785; 99% CI, 1.589-2.005; parity 2: aHR, 1.434; 99% CI, 1.292-1.592; parity ≥3: aHR, 1.916; 99% CI, 1.712-2.144). Conclusion Tibolone and CEPM use were associated with reduced POP risk in postmenopausal women. Other MHT types showed no significant association with POP.
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spelling doaj-art-7b2207064cde4f85ab8f93383e9d2e9e2025-08-20T03:48:27ZengKorean Society of Obstetrics and GynecologyObstetrics & Gynecology Science2287-85802025-05-0168321022010.5468/ogs.240718866Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort studyHee-Yeong Jung0Tae-Ran Kim1Gwan Hee Han2Jin-Sung Yuk3 Apple Obstetrics and Gynecology Clinic, Seoul, Korea Apple Obstetrics and Gynecology Clinic, Seoul, Korea Department of Obstetrics and Gynecology, Inje University Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Korea Department of Obstetrics and Gynecology, Inje University Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, KoreaObjective To analyze the relationship between pelvic organ prolapse (POP) and menopausal hormone therapy (MHT). Methods This retrospective cohort study used Korean National Health checkup and insurance data from 2002 to 2019. Women who used MHT for more than 6 months between 2002 and 2011 were included in the MHT group; postmenopausal women with no MHT use comprised the non-MHT group. Results In the non-MHT group, there were 1,001,350 women, while the MHT group had 353,206 women. Tibolone (adjusted hazard ratio [aHR], 0.87; 99% confidence interval [CI], 0.818-0.926) and combined estrogen plus progestin by the manufacturer (CEPM) (aHR, 0.821; 99% CI, 0.758-0.89) were associated with reduced POP risk. The other oral MHT groups and the transdermal estrogen group showed no significant difference in POP risk compared with the non-MHT group (other oral MHT: aHR, 1.045; 99% CI, 0.941-1.161) (transdermal estrogen: aHR, 1.252; 99% CI, 0.731-2.145). Lower body mass index (BMI) (<18.5) was associated with reduced POP risk (aHR, 0.822; 99% CI, 0.698-0.968), while a BMI between 23 and 29.9 was associated with increased risk (BMI 23-24.9: aHR, 1.143; 99% CI, 1.088-1.2) (BMI 25-29.9: aHR, 1.173; 99% CI, 1.12-1.228). All parities had a higher POP risk than parity 1 (parity 0 or no response: aHR, 1.785; 99% CI, 1.589-2.005; parity 2: aHR, 1.434; 99% CI, 1.292-1.592; parity ≥3: aHR, 1.916; 99% CI, 1.712-2.144). Conclusion Tibolone and CEPM use were associated with reduced POP risk in postmenopausal women. Other MHT types showed no significant association with POP.http://www.ogscience.org/upload/pdf/ogs-24071.pdfestrogenhormone replacement therapymenopausepelvic organ prolapsetibolone
spellingShingle Hee-Yeong Jung
Tae-Ran Kim
Gwan Hee Han
Jin-Sung Yuk
Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study
Obstetrics & Gynecology Science
estrogen
hormone replacement therapy
menopause
pelvic organ prolapse
tibolone
title Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study
title_full Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study
title_fullStr Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study
title_full_unstemmed Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study
title_short Relation between pelvic organ prolapse and menopausal hormone therapy: nationwide cohort study
title_sort relation between pelvic organ prolapse and menopausal hormone therapy nationwide cohort study
topic estrogen
hormone replacement therapy
menopause
pelvic organ prolapse
tibolone
url http://www.ogscience.org/upload/pdf/ogs-24071.pdf
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