Korean J Fam Pract. 2018; 8(5): 759-763  https://doi.org/10.21215/kjfp.2018.8.5.759
A Comparison of Tendency of Suicidal Ideation between the Groups that Begin Hormone Replacement Therapy before and after the Onset of Menopause: The Korean National Health and Nutrition Examination Survey IV from 2007-2009
Se-Mi Park, Yong-Hwa Jung, No-Jin Lee, Keun-Joo Bae, Ji-Hyun Kim, Seok-Won Park, Kyung-Hwan Cho, Yang-Hyun Kim*
Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
Yang-Hyun Kim
Tel: +82-2-920-6928, Fax: +82-2-928-8083
E-mail: mrchir@naver.com
ORCID: http://orcid.org/0000-0003-3548-8758
Kyung-Hwan Cho and Yang-Hyun Kim contributed equally to this study.
Received: July 25, 2017; Revised: October 10, 2017; Accepted: October 12, 2017; Published online: October 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Many women experience symptoms of menopause for which they are recommended hormone replacement therapy (HRT). However, no study has shown whether HRT administration before the onset of menopause aids mental status such as in cases of depression and suicidal ideation. Here, we investigated this issue.
Methods: We analyzed the data from the Korean National Health and Nutrition Examination Survey, 2007–2009. We included 180 postmenopausal women to whom HRT was administered. We studied the relationship between the point at which HRT was started and the mental status of the women using self-reported questionnaires.
Results: The tendency toward suicidal ideation was higher in the HRT before menopause onset than the HRT after menopause onset group (P<0.05). After adjustment for underlying diseases, the odds ratio for suicidal ideation was 0.475 (0.190–1.190; P<0.05) in the after group. The study had several limitations. We could not assess the difference in severity of menopausal symptoms between the before and after group. Suicidal ideation during the preceding 1 year was assessed; thus, we were unable to identify the participants who had previously recovered from suicidal ideation. An insufficient number of individuals were assessed with regards to depression and suicidal ideation.
Conclusion: When physicians recommend early HRT administration, they must pay attention to patient mental status. If they notice mental or mood problems, continuous close observation and proper intervention are needed.
Keywords: Hormone Replacement Therapy; Depression; Suicidal Ideation; Menopause
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