Low sexual function and its associated risk factors in pre- and postmenopausal women without clinically significant depression

Objectives

To investigate the low sexual function and its associated risk factors in pre- and postmenopausal women without clinically significant depression.

Methods

Cross-sectional study with 180 women aged between 19 and 60 years who admitted to our outpatient clinic. Sexual function was assessed by female sexual function index and clinically significant depression was measured by Beck depression inventory test.

Results

The rate of low sexual function was 85.9% in postmenopausal (OR 2.9, 95% CI 1.8–4.8) and 47.7% in premenopausal women (OR 0.4, 95% CI 0.3–0.5) (p < 0.0001). The postmenopausal group reported significantly lower desire, arousal, lubrication, orgasm, satisfaction and pain scores than controls (p < 0.0001, for all of them). Low sexual function was positively correlated with age (r = 0.37, p < 0.0001), menopausal status (r = 0.40, p < 0.0001), gravidity (r = 0.44, p < 0.0001), parity (r = 0.43, p < 0.0001), abortion rates (r = 0.27, p = 0.001) and marriage period (r = 0.40, p < 0.0001). There were also significant negative correlations between low sexual function and education (r = −0.39, p < 0.0001) and family income (r = −0.29, p < 0.0001). However, multivariate regression analysis demonstrated that education, family income and menopausal status were the only independent variables for low sexual function after adjusted for age, gravidity, parity, abortion, marriage period and menopausal status.

Conclusion

Low sexual function was relatively high in postmenopausal women without clinically significant depression. Education, family income and menopausal status were the independent risk factors for low sexual function. Investigation of female sexuality was essential for these patients.     

Differential factors associated with hot flashes in Chinese perimenopausal and postmenopausal women

Objective

This study investigated factors associated with hot flashes in Chinese perimenopausal and postmenopausal women.

Methods

This cross-sectional study recruited Chinese women aged 40–60 years who were perimenopausal or postmenopausal and examined factors associated with hot flashes. Participants completed a questionnaire detailing demographic information, characteristics of menstruation, reproductive history, use of hormone replacement therapy or oral contraceptives, personal lifestyle factors (exercise, multivitamin use, soy products use, diet), and symptoms of hot flashes. Height, weight, blood pressure, and waist and hip circumference were also measured.

Results

A total of 1399 participants (817 perimenopausal women and 582 postmenopausal women) completed the study. In perimenopausal women, college or higher education decreased the prevalence of hot flashes (odds ratio (OR) 0.63; 95% confidence interval (CI) 0.46–0.86). In postmenopausal women, an omnivorous diet decreased the prevalence of hot flashes (OR 0.38; 95% CI 0.17–0.85). Strenuous exercise (≥3 times a week) increased the prevalence of hot flashes (OR 1.41; 95% CI 1.08–1.83) in perimenopausal women.

Conclusions

It is possible that modifiable risk factors for hot flashes exist in Chinese perimenopausal and postmenopausal women. Future studies with larger populations are needed to confirm these findings.     

绝经妇女外周血单个核细胞骨代谢调控因子表达变化

目的:探讨绝经妇女雌激素水平下降所致免疫细胞骨代谢调控因子变化。方法:纳入绝经妇女、未绝经妇女各30例,电化学发光法检测血清雌二醇(E2)水平;RT-PCR法检测外周血单个核细胞(PBMC)中雌激素受体(ERα、ERβ)、白细胞IL-6、TNFα-。核因子κB受体活化因子配基(RANKL)、核因子κB受体活化因子(RANK)mRNA表达;ELISA检测血清IL-6、TNFα-蛋白含量;双能X线骨密度仪检测腰椎2~4(L2-4)前后位骨密度(BMD)。结果:与未绝经组比较,绝经妇女E2水平明显下降,腰椎BMD显著降低(P<0.05),外周血单个核细胞ERα、ERβmRNA表达明显降低(P<0.05),IL-6、TNFα-、RANKL、RANKmRNA表达明显升高(P<0.05),IL-6及TNFα-血清蛋白含量明显升高(P<0.05)。相关性分析显示PBMC中ERα、ERβmRNA表达与血清E2水平、腰椎BMD呈显著正相关性(P<0.05),PBMC中IL-6、TNFα-、RANKL、RANKmRNA表达与血清E2水平、腰椎BMD呈显著负相关性(P<0.05)。结论:绝经后妇女雌激素水平下降伴随着外周血免疫细胞雌激素受体转录水平下降,同时,炎性骨吸收调控因子和溶骨性细胞因子表达升高,这种变化可能在绝经后骨丢失中发挥重要作用。     

Bone turnover and its relationship with bone mineral density in pre- and postmenopausal women with or without fractures

Objective: This work was carried out in order to investigate possible relationships between bone turnover rate, as evaluated by bone biomarkers and skeletal mass, as evaluated by bone mineral density (BMD). Method: Fifty-eight normal women and 30 female patients with osteoporotic fractures were enrolled. Three groups were defined: (1) fertile subjects (n=24), mean age 33.7±8.1 years; (2) postmenopausal women (n=32, including 11 patients with fractures) whose BMD values, in terms of T score, were less than −2.5 S.D. below the young adult mean obtained in our laboratory (mean age 61.7±7.9 years; and years since menopause (ysm), 12.6±8.3); (3) postmenopausal women (n=32, including 19 patients with fractures) whose BMD values in terms of T score, were below −2.5 S.D. (mean age 62.9±8.6 years; and ysm 15.9±9.0). Groups II and III characterised, by inclusion criteria, by significant different mean BMD values, were similar as far as chronological and menopausal age were considered. Metabolic tests included a short urine collection to determine calcium, hydroxyproline, cross-linked N-telopeptides of type I collagen (NTx) and creatinine (Cr); half-way through this collection, a blood sample was taken for the measurement of total alkaline phosphatase activity (ALP) and tartrate-resistant acid phosphatase activity (TRAP). BMD at lumbar spine was evaluated. Results: There were significant differences amongst the three groups in mean ALP (P<0.001, by analysis of variance) TRAP (P<0.006) and NTx/Cr (P<0.001) values, but not as far as mean values of calcium/Cr or hydroxyproline/Cr ratios were concerned. Considering the group as a whole, there were significant inverse correlations between NTx/Cr, ALP, TRAP and BMD controlling for both age (r=−0.392, P<0.001; r=−0.447, P<0.001 and r=−0.327, P<0.002, respectively) and ysm (r=−0.374, P<0.001; r=−0.474, P<0.001 and r=−0.333, P<0.002). Conclusions: Our results indicate, that, even after controlling for both ageing and oestrogen status, there is an inverse relationship between bone mass (that at a given time represents the balance of all previous metabolic events) and a biochemical marker (which reflects bone turnover at the time of examination). These findings are in line with the belief that increased bone turnover should be regarded as a risk factor for osteoporosis. Furthermore, our results indicate that, unless there is no increase of hepatic isozyme, total ALP still maintains a possible role as a first analysis to evaluate bone turnover before requesting markers with greater specificity, sensitivity but also more expensive and whose analysis is sometimes time-consuming.     

Risk factors related to the presence and severity of hot flushes in mid-aged Ecuadorian women

Background

Several studies drawn from the Ecuadorian population have previously reported that more than half of mid-aged women present hot flushes, which can impair their quality of life. However up-to-date risk factors for their presence and severity have not been assessed.

Objective

To assess hot flush frequency and intensity and related risk factors among middle-aged Ecuadorian women.

Methods

In this cross-sectional study, 1154 healthy women aged 40–59 years, visiting healthcare centers of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the first item of the Menopause Rating Scale (MRS) and a questionnaire containing female and partner socio-demographic data.

Results

Mean age of the entire sample was 48.8 ± 5.6 years (median 48), a 48.7% had 12 or less years of schooling, 52.8% were postmenopausal, 43.6% lived at high altitude, 56.8% were married and 10% were on hormonal therapy (HT). Hot flushes accounted for 56% (n = 646) of the whole sample, of which 29.1% and 9.1% were respectively graded as severe and very severe. Logistic regression determined that female sedentarism (OR: 2.42, CI 95% [1.63–3.59]), accessing a free healthcare system (OR: 1.96, CI 95% [1.30–2.96]), living at high altitude (OR: 1.82, CI 95% [1.14–2.90]) and having a partner abusing alcohol (OR: 1.92, CI 95% [1.09–3.35]) were significant risk factors related to the presence of hot flushes. The regression model also determined that among women with hot flushes (n = 646), sedentarism (OR: 1.73, CI 95% [1.14–2.62]) and having a partner with erectile dysfunction (OR: 2.57, CI 95% [1.44–4.59]) were significant risk factors related to severe/very severe hot flushes whereas married status (OR: 0.53, CI 95% [0.32–0.86]), living at high altitude (OR: 0.46, CI 95% [0.26–0.78]) and partner healthiness (OR: 0.59, CI 95% [0.36–0.95]) were not.

Conclusion

To the best of our knowledge this is the first and largest study assessing hot flushes in a mid-aged Ecuadorian population. We found that the presence and severity were not significantly related to age and hormonal status yet to other individual female/male characteristics and the demography of the studied population.     

Menopause and myocardial infarction risk among employed women in relation to work and family psychosocial factors in Lithuania

Objectives

To assess the relationship between menopause and age at menopause and the risk of the first non-fatal myocardial infarction taking into account the possible influence of psychosocial job characteristics, marital stress, level of social support, educational level, occupation, age and traditional ischemic heart disease risk factors.

Methods

Population-based case–control study among 35–61 years old employed women in Kaunas, Lithuania. Totally 122 myocardial infarction cases and 371 controls were interviewed in 2001–2004. The logistic regression analysis was performed.

Results

Younger age at menopause (≤40 years) showed a tendency for increased myocardial infarction risk (OR = 1.78; 95% CI 0.39–8.07) after adjustments for age, smoking, arterial blood pressure and body mass index. However further adjustment for job demands, job control, social support, marital stress, education level, occupation decreased the risk (OR = 1.16; 95% CI 0.27–5.01). In the fully adjusted model OR for postmenopausal women was 1.15; 95% CI 0.48–2.75. The association between low job control and myocardial infarction showed step increase, women in the lowest quartile of job control had the highest myocardial infarction risk (OR = 4.51; 95% CI 1.90–10.75), while those in the second and third quartiles showed modest risk. Marital stress was an independent myocardial infarction risk factor for employed women (adjusted OR = 2.36; 95% CI 1.07–5.19).

Conclusions

Menopausal status and younger age at menopause showed only a tendency for increase in myocardial infarction risk among the employed women in Kaunas, Lithuania. Adverse psychosocial job characteristics as low job control, as well as marital stress play more important role in the development of the first myocardial infarction.     

Symptom prevalence during menopause and factors associated with symptoms and menopausal age. Results from the Norwegian Hordaland Women's Cohort study

Objectives

To describe symptoms during the menopausal transition and age at menopause in a representative Norwegian female cohort over a ten year period, to analyze factors associated with frequency and burden of symptoms and influence on self-rated health.

Study design

2229 women aged 40–44 years at inclusion, randomly selected from a national health survey in Hordaland County, Norway, and followed with seven postal questionnaires from 1997 throughout 2009. Data for 2002 women (90%) were eligible for analyses.

Results

In a longitudinal analysis, 36% of the women reported daily hot flushes in one or more questionnaires, whereas 29% did not experience hot flushes at all. The prevalence of daily hot flushes increased from 2% at age 41–42 to 22% at age 53–54, decreasing to 20% at age 55–57. The odds ratio for reporting daily hot flushes vs. never/seldom for daily smokers was 1.6 (1.24–2.10). Women in the lowest education group had an OR = 1.8 (1.21–2.56) for reporting daily hot flushes compared to women with a university degree. There was no relation between the symptom burden and degree of physical exercise, overall feeling of health, BMI, family income, parity or menarche age as recorded at baseline. The mean age for final menstruation period (FMP) in the cohort was 51.1 (50.9–51.3) years. Smokers had a mean age of FMP 0.9 years earlier compared to the non-smokers.

Conclusions

Daily smoking and educational level were independent risk factors for experiencing daily menopausal symptoms. Degree of physical exercise, BMI, parity or menarche age did not have significant influence.     

Menopausal symptoms and associated factors in HIV-positive women

Objective

To evaluate menopausal symptoms and their associated factors in HIV-positive women.

Methods

A cross-sectional study was conducted with 537 women of 40–60 years of age, 273 of whom were HIV-positive and 264 HIV-negative. The women were interviewed to obtain data on their sociodemographic characteristics and menopausal symptoms.

Results

The mean age of the seropositive women was 47.7 ± 5.8 years compared to 49.8 ± 5.3 for the seronegative women (p < 0.001). Bivariate analysis showed a lower prevalence of vasomotor symptoms in the seropositive group (p = 0.009), specifically hot flashes (p < 0.002) and sweating (p = 0.049). Vaginal dryness was also less prevalent in this group (p < 0.005). There were no statistically significant differences between the groups with respect to depression or insomnia. Multiple analysis showed that hot flashes were associated with being peri- or postmenopausal (PR = 2.12; 95%CI: 1.52–2.94). Vaginal dryness was less common in women without a partner (PR = 0.67; 95%CI: 0.49–0.90) and was associated with older age (PR = 1.03; 95%CI: 1.01–1.06) and being in the peri- or postmenopause (PR = 1.69; 95%CI: 1.10–2.60). Depression was inversely associated with being employed (PR = 0.74; 95%CI: 0.58–0.96) and directly associated with the presence of chronic diseases (PR = 1.30; 95%CI: 1.01–1.067). Insomnia was associated with a lower body mass index (PR = 0.96; 95%CI: 0.95–0.97) and with being peri- or postmenopausal (PR = 1.48; 95%CI: 1.11–1.97). No correlation was found between HIV serological status and any of the menopausal symptoms.

Conclusions

In this study, after controlling for confounding variables, HIV infection was not found to be associated with vasomotor, genitourinary or psychological symptoms or with insomnia.     

Identification of the risk factors for osteoporosis among postmenopausal women

ObjectivesThe aim of this study was to determine the effect of different durations of menopause at the time of bone mineral density (BMD) measurement and of different age at menopause intervals on the prevalence of osteopenia and osteoporosis among untreated postmenopausal women. We also assessed related factors leading to low BMD.MethodsA total of 2769 postmenopausal women who had not taken any anti-osteoporosis treatment and/or hormone replacement therapy were divided into three groups according to duration of menopause at the time of BMD measurement. The women were also evaluated in four different age groups according to their age at menopause onset. Multinomial logistic regression analysis was used to determine related factors leading to low BMD. Investigated parameters include demographic characteristics, plasma glucose, lipids, and lipoproteins.ResultsAccording to World Health Organization (WHO) criteria, among 2769 patients, 449 (16.2%) were identified as having osteoporosis, 1085 (39.2%) as having osteopenia, and 1235 (44.6%) as having normal BMD. Osteoporosis was determined in 10.6% and 16.2% of women with menopause duration of 0–3 years and 4–7 years, respectively, whereas this rate was 31.9% in women with menopause duration of over 7 years (p = 0.001). The percentages for osteopenia remained constant among the three different menopause durations (0–3 years: 37.2%, 4-7 years: 42.1%, and >7 years: 40.9%). Thirty percent of women with age at onset of <40 years were osteoporotic. However, the percentages of women with osteoporosis among the other age groups were similar (40–46 years: 18.3%, 47–52 years: 14.1%, and >52 years: 15.4%). The percentages for osteopenia remained relatively constant among the four age groups (36.7, 40, 39.1 and 39%). According to the multinomial logistic regression analysis, duration of menopause at the time of BMD test and parity were positively correlated with both osteoporosis and osteopenia, while glucose level was negatively correlated with both osteoporosis and osteopenia. Age at menopause was negatively correlated only for osteoporosis. Low-density lipoprotein cholesterol (LDL-c) level may be accepted as a clinically significant factor for osteopenia (OR: 1.01; CI_95%: 1.00–1.02). No differences were determined in the prevalence of osteopenia and osteoporosis in women with menopause duration of >7 years when evaluated according to the four menopause age groups as described before (p = 0.74). Contribution to the regression model was 0.8% by age at menopause, 5.6% by menopause duration at time of BMD measurement, 5.8% by both factors.ConclusionAccording to our results, osteoporosis is related more to the duration of menopause at the time of BMD measurement rather than the age at menopause among untreated postmenopausal women. High parity was determined as another risk factor for low BMD.     

Raloxifene therapy interacts with serum osteoprotegerin in postmenopausal women

OBJECTIVES: Osteoprotegerin (OPG) is a protein expressed by osteoblasts that, linking the receptor activator of nuclear factor kappaB (RANK) ligand (RANKL), produced by osteoblasts, blocks the process of osteoclastic differentiation and modulates osteoclastic apoptosis. Raloxifene (RAL) stimulates the production of OPG from osteoblasts, as demonstrated in vitro, carring out their antiresorption activity, at least in part, as means of the OPG/RANK/RANKL system. The aim of this study was to evaluate in vivo if the RAL treatment of postmenopausal women was associated to changes in serum OPG; moreover, to evaluate the serum changes of bone turnover modulators interleukin-6 (IL-6) and C-telopeptides of type-1 collagen (CrossLaps). METHODS: A prospective, randomized, placebo-controlled study was designed. A group of consecutive healthy postmenopausal women (n=40) referred to II Menopause Centre of the Department of Gynaecology of Second University of Naples for climacteric syndrome was enrolled and divided in two groups: (n=20) postmenopausal women received for 6 months oral raloxifene (60 mg/day) versus (n=20) postmenopausal women received placebo tablets. RESULTS: Serum OPG levels in postmenopausal women after RAL treatment are statistically significant increased (P<0.001) versus baseline (P=0.007) versus placebo. CONCLUSIONS: These in vivo data demonstrate that RAL could improve osteoporosis, also through an increase of OPG production by osteoblasts.     

Leptin production in pre- and postmenopausal women

OBJECTIVES: To investigate the differences in leptin production between pre- and postmenopausal women. METHODS: Subjects were 75 pre- and 75 postmenopausal women. Age, height, weight, and body mass index (BMI, wt/ht(2)) were recorded. Serum leptin levels were measured by RIA. Total body fat mass and percentage of body fat mass were measured by whole-body scanning with dual-energy X-ray absorptiometry. Serum leptin levels, the ratio of serum leptin levels to total body fat mass (leptin-fat mass ratio), baseline characteristics, and anthropometric variables were compared between the two groups. In all subjects (n=150), relationship of serum leptin levels with menopausal status (pre- and postmenopause) was investigated by univariate and multiple regression analysis. RESULTS: Serum leptin levels in premenopausal women 8.4+/-4.8 ng/ml, which did not differ from that in postmenopausal women (9.2+/-7.1 ng/ml). Total body fat mass, percentage of body fat mass, and BMI did not differ between the two groups. Leptin-fat mass ratio in premenopausal women was 0.43+/-0.17 ng/ml/kg, which did not differ from that in postmenopausal women (0.44+/-0.24 ng/ml/kg). On both univariate and multiple regression analysis, serum leptin levels were not correlated with menopausal status. CONCLUSIONS: Menopausal status does not have a significant impact on leptin production.     

Endometrial bleeding in postmenopausal women: with and without hormone therapy

The aim of this study was to present a review of the potential mechanisms involved in the occurrence of endometrial bleeding in postmenopausal women using hormone therapy. Selected literature on the incidence of bleeding in postmenopausal women using estrogen progestogen therapy was reviewed. The incidence of spotting and bleeding in women using continuous-combined hormone therapy was presented. Relevant articles related to the role of angiogenic factors and vasculogenesis in the endometrium, endometrial leukocytes, and endometrial metalloproteinases were used for the review. The cause or etiology of endometrial bleeding with hormone therapy is unknown. Several options are known to alter angiogenesis or be involved in tissue remodeling during normal menstruation. Vascular endothelial growth factor and thrombospondin-1 are proangiogenic and antiangiogenic factors that could cause dysfunction in vasculogenesis that could result in blood vessel fragility and bleeding. The role of pericytes in maintaining vessel morphology and integrity is discussed. Endometrial leukocytes and metalloproteinases are involved in normal menstruation, but their role in postmenopausal bleeding is not clear suggesting involvement of mechanisms in the bleeding. There is limited information on clinical investigation into the etiology of postmenopausal bleeding associated with hormone therapy. The major cause of hormone therapy-related bleeding is unknown. Alterations in angiogenic factors that could result in vascular dysfunction and vessel breakdown provide a working hypothesis as to the potential cause of vessel breakdown.     

Absorption of percutaneous oestradiol in postmenopausal women

Seven postmenopausal women have been treated daily with 3 mg oestradiol percutaneously applied upon the skin. Blood samples were drawn at 8-h intervals during a 4-day period and on days 5, 7 and 9 from the beginning of the treatment. Plasma oestradiol (E2), oestrone (E1), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined by radioimmunoassay on these samples.The plasma E2 level was significantly increased at the 12th hour (73 ± 17 pg/ml) but the maximal plasma concentration was obtained only at the third day of treatment (110 ± 24 pg/ml). Thereafter the mean plasma concentration was more stable.Increments in E1 were smaller and the plasma $\text{E2}\text{E1}$ ratio was 1.51.Plasma FSH and LH did not change significantly during the course of the treatment.Thus the percutaneous administration of E2 appears to be an effective and safe method of delivering E2 into the circulation, and mimicking the physiologic condition. The advantages of this method are discussed.     

Measurement of serum estrogen and estrogen metabolites in pre- and postmenopausal women with osteoarthritis using high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry

Although 17β-estradiol (E₂) deficiency has been linked to the development of osteoarthritis (OA) in middle-aged women, there are few studies relating other estrogens and estrogen metabolites (EMs) to this condition. We developed a high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (HPLC-ESI-MS/MS) method to measure the levels of six EMs (i.e., estrone, E₂, estriol, 2-hydroxyestrone, 2-hydroxyestradiol, and 16a-hydroxyestrone) in healthy pre- and postmenopausal women and women with OA. This method had a precision ranging from 1.1 to 3.1% and a detection limit ranging from 10 to 15 pg. Compared to healthy women, serum-free E₂ was lower in the luteal and postmenopausal phases in women with OA, and total serum E₂ was lower in postmenopausal women with OA. Moreover, compared to healthy women, total serum 2-hydroxyestradiol was higher in postmenopausal women with OA and total serum 2-hydroxyestrone was lower in both the luteal and follicular phases in women with OA. In conclusion, our HPLC-ESI-MS/MS method allowed the measurement of multiple biochemical targets in a single assay, and, given its increased cost-effectiveness, simplicity, and speed relative to previous methods, this method is suitable for clinical studies.     

子宫内膜息肉发病相关危险因素临床分析

目的 分析子宫内膜息肉（EP）发病的相关危险因素。方法 选取 2016年1月1日~2018 年1月1日在我院妇科就诊行宫腔镜检查及病理组织学确诊为子宫内膜息肉患者456例为观察组,病理提示子宫内膜未见明显异常的102例作为对照组,记录两组患者的年龄、体质指数（BMI）、腰围（WC）、异常出血情况、子宫内膜厚度、是否绝经,有无高血压、糖尿病、子宫肌瘤、子宫腺肌症、宫颈息肉、多囊卵巢综合征,用SPSS统计软件进行单因素及多因素Logistic回归分析。结果 子宫内膜息肉发病年龄集中在30~49岁,占56.36%,主要临床症状是异常子宫出血,占60.96%,经单因素分析结果发现,与EP发病有关的影响因素包括糖尿病、肥胖、胰岛素抵抗、多囊卵巢综合征、子宫腺肌症及宫颈息肉（P＜0.05）,而高血压、高脂血症、子宫肌瘤无明显关系（P＞0.05）。Logistic回归分析显示绝经、胰岛素抵抗及子宫腺肌症是EP发生的危险因素。结论 绝经、子宫腺肌症及胰岛素抵抗是EP发病的危险因素,而对于有异常子宫出血、子宫颈息肉、肥胖、糖尿病、多囊卵巢综合征患者也存在EP高发的可能,在临床中应加强对此类人群的筛查。     

Five-year compliance with hormone replacement therapy in postmenopausal Chinese women in Hong Kong

Objectives: To assess 5-year compliance with hormone replacement therapy (HRT) in Hong Kong Chinese women and the reasons for long-term compliance or non-compliance. Methods: A telephone survey using a standardized questionnaire was conducted in 187 postmenopausal women who had commenced HRT in a referral-only specialist clinic of a university teaching hospital 5 years previously. Over this 5-year period, the cohort had been referred out to primary care doctors once they had become stabilized on treatment. Results: The 5-year compliance rate was 71.1%. The overall compliance rates were nearly the same from 2 and 5 years. ‘Doctors’ advice’ was the most important reason for maintenance of long-term compliance, accounting for 88.0% of all compliant cases. The most frequent reason for non-compliance was that of the experience of side effects. Other important reasons were fear of cancer, fear of other side effects, and discouragement from other doctors. Overall, 16.0% of women expressed concern regarding potential side effects or risk of breast cancer. Younger age at menopause and at time of initial consultation, shorter duration of menopause at presentation and previous history of hysterectomy were associated with a higher degree of compliance at 5 years. Presence or absence of menopausal symptoms, on the other hand, was not a significant factor. Conclusions: The 5-year compliance rate in this cohort of Hong Kong Chinese women was comparable to that reported from predominantly Caucasian populations. The physicians’ role in encouraging postmenopausal women to achieve long-term HRT compliance was observed.