Although plasma estrogen levels are closely associated with onset of these risk factors, most gynecologists do not manage women with risk factors. We carried out a questionnaire, AZD6244 as demonstrated in Table 1, among obstetrics and gynecology (OB-GYN) doctors and evaluated the degree to which they can manage women with dyslipidemia, hypertension, diabetes mellitus, smoking, and chronic kidney disease. The doctors surveyed worked in a postgraduate training hospital designated by the Japan Society of Obstetrics and

Gynecology (JSOG) and the Japan Society for Menopause and Women’s Health. We also carried out a questionnaire among women who admitted to these clinics and evaluated the prevalence of these risk factors before and after menopause (Table 2). In questionnaire 1 (Table 1),

we received answers from 121/784 facilities (15.4%) and received 1201 answers from OB-GYN doctors in the membership of the JSOG. We were able to analyze 7.6% (1201/15 625 doctors) of members in this study (Table 3). Results showed that 25% of OB-GYN doctors usually examine plasma lipid levels, and 13% of doctors can manage women with dyslipidemia in their clinics. In all OB-GYN doctors, 58% of them whose subspecialty is women’s health can manage women with dyslipidemia in their clinics (Table 4). In contrast to lipid management, 76% and 70% of doctors measure blood pressure and blood glucose, respectively. However, 7% of them treat women with hypertension, Doxorubicin ic50 and 2% treat women with old diabetes mellitus in their clinics (Tables 5 and 6). In analyses

from questionnaire 2, prevalence of dyslipidemia increased from 11% during premenopause to 32% at postmenopause. Similarly, prevalence of hypertension, diabetes mellitus, and chronic kidney disease also increased after menopause (Table 7). In total, 37.1% (n = 802) of women have risk factors for cardiovascular disease. The percentage of women who have risk factors increased from the premenopausal to the postmenopausal stage (one risk factor, 12% to 34%; two risk factors, 2.4% to 11.0%; three risk factors, 0.5% to 2.6%) (Table 8). Although investigation in this study showed that risk factors for cardiovascular disease, such as dyslipidemia, hypertension, diabetes mellitus, smoking, and chronic kidney disease, increase after menopause, few OB-GYN doctors can manage women with those risk factors. Education for OB-GYN doctors may be needed to prevent the onset of cardiovascular disease in women. We are extremely grateful to the many facilities that participated in our survey. A consensus meeting was held at the 64th JSOG Annual Meeting about the revised version of hormone replacement therapy (HRT) guideline 2009 and received comments or questions. Based on these comments or questions, the HRT guideline 2009 was revised as much as appropriate and finally the HRT guideline 2012 was published on the 15 September 2012.