Page.1

Asian Menopause Survey

March 2007

Hans Rekers

VP Medical Affairs

NV Organon

Page.2

ObjectivesObjectives

To provide :

Current insights in women’s thoughts and

feelings about menopause and HRT: Their views Their perceptions Their concerns Their fears Their beliefs Their experiences Their needs

Today

Page.3

European Menopause Survey

2005

March 8th 2005

By Linda Abrams

Healthcare

Page.4

Research design & methodologyResearch design & methodology

Asia Pacific Europe

Women’s age 45-60 45-60

Sample size 1000 4201

Time March 2006 January 2005

Countries China, Hong Kong, Taiwan,Malaysia,

Thailand

Netherlands, UK Belgium, Spain ,

Germany, France, Switzerland,

Interview Face to face Telephone

Page.5

Survey on Menopause in ASIA PACIFIC

AGE

GROUP

MALAYSIA CHINA HONG KONG

TAIWAN THAILAND

45 – 49 105 90 30 45 45

50 – 55 135 150 50 75 75

56 – 60 60 60 20 30 30

TOTAL 300 300 100 150 150

Total Number of Respondents = 1000

Sample

Page.6

Questionnaire designQuestionnaire design

Demographic profile

Attitudes, Interests and Opinions regarding to:

Menopause Breast Sexual well-being

Survey on Menopause in ASIA PACIFIC

Page.7

FindingsFindings

Menopause

Breast

Sexual well-being

Page.8

Q17. Feeling about the menopause

7% 39% 28% 23% 3%Total

(N=1000)

Affects me a lot Affects me somewhatDoes not affect me that much Does not affect me at allDon't know

46%

Almost half the Asian menopausal women are affected by menopause symptoms

Page.9

51% 51% 48% 49% 43%

11% 9% 8% 7% 11%

38% 40% 44% 44% 42%

4%

0%

20%

40%

60%

80%

100%

Sleeplessness Irritability Moodswings/mood

changes

Headaches ormigraines

Reduced sexdrive

Yes, mild Yes, severe No Don't want to share

Total (N=1000)Total (N=1000)

% of women

Q15 Currently experiencing or have experienced any symptoms in the past 5 years?

Base: All respondents

Symptoms experienced are in general mildSleeplessness most mentioned

Page.10

Reasons to seek treatment in Asia

42

37

35

32

25

20

17

13

9

12

0 10 20 30 40 50 60 70

Sleeplessness

Hot flushes

Headaches/ migraine

Mood swings

Irritability

Depression

Reduced sex drive

Vaginal pain

Involuntary loss of urine

Don't know/ all the same

% women

Page.11

Reasons to seek treatment in Europe

54557810

141517

2159

0 10 20 30 40 50 60

Hot flushes

Sleeplessness

Mood swings

Irritability

Depression

Headaches/ migraine

Vaginal pain

Reduced sex drive

Involuntary loss of urine

Operation

Menstruation problems

Other

Base: women who sought treatment for menopausal

symptomsn=2721

% women

Page.12

31

8

35

22

19

5

55

42

0 10 20 30 40 50 60

HRT

Natural or herbal

Anti-depressants

None of these

Ever used

Current use

% women

Usage of treatmentsUsage of treatments inin EuropeEurope

Page.13

37

2

45

7

32

1

59

19

0 10 20 30 40 50 60

HRT

Natural or herbal

Anti-depressants

None of these

Ever used

Current use

% women

Usage of treatmentsUsage of treatments inin AsianAsian

Page.14

HRT usage in Asia by country/regionsHRT usage in Asia by country/regions

2.1

11

30.6

25

15.3

0.9

69.3

12

6.3

0

5

10

15

20

25

30

35

China Malaysia Taiwan Thailand Hongkong

ever used

current use

% o

f w

om

en

Page.15

General feeling about HRTGeneral feeling about HRT

Negative

Positive

Don't know 48%

Negative

43%

9%

Page.16

45%

32%

27%

24%

9%

0% 10% 20% 30% 40% 50%

Increased risk of breast cancer

Weight gain

Will not alleviate symptoms

Info about increased risk of heartdisease

Breast problems

% of women

Largest hurdles preventing the use of HRTLargest hurdles preventing the use of HRT

Page.17

Largest hurdles preventing the use of HRTLargest hurdles preventing the use of HRT

25%

8%17% 17%

38%25%

6% 6%

24%

41%

12%8%

17%

25%

19%

25%13%

13%

47%6%

41% 12%

18%

0%

20%

40%

60%

80%

Others, spontaneous

First, spontaneous

Hong Kong (N=12)Hong Kong (N=12) Thailand (N=16)Thailand (N=16) Malaysia (N=17)Malaysia (N=17)

% of women

Page.18

Few women have ever considered HRT.Far more would be confident to use upon the doctor’s advise

Q35. Confidence to use HRT with doctor’s advice

Q36. Ever considered treatment for menopausal symptoms

6%

31%

19%

5%

3%

41%

47%

63%

34%

32%

42%

26%

11%

14%

34%

36%

25%

9%

9%

7%

21%

11%

17%

21%

5%

10%12%

4%

2%

Malaysia(N=162)

Thailand(N=116)

Hong Kong(N=72)

Taiwan(N=107)

China(N=128)

Total (N=585)

Agree strongly Agree slightly

Disagree slighty Disagree strongly

Don't know

25%

14%

24%

11%

23%

54%

71%

76%

81%

56%

66%

21%

14%

8%

21%

14%20%

Malaysia(N=98)

Thailand(N=14)

Hong Kong(N=63)

Taiwan(N=75)

China (N=71)

Total (N=321)

YES NO Don't know

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FindingsFindings

Menopause

Breast

Sexual well-being

Page.20

Self breast examinationSelf breast examination

30%17%

83%70%

0%

20%

40%

60%

80%

100%

Asia (N=1000) Europe(N=4201)

% o

f w

om

en

YES NO

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50% 45%

55%50%

0%

20%

40%

60%

80%

100%

Asia (N=1000) Europe (N=4201)

% o

f w

om

en

YES NO

Worries about getting breast cancerWorries about getting breast cancer

Page.22

Perceived risk factor for developing breast cancer ((EuropeEurope))

7

8561

271917

1614

11

99

5

0 10 20 30 40 50 60 70 80 90 100

Hereditary factors

HRT

Increased breast density

Natural hormone levels

Removal of ovaries

Birth of first child at older age

Weight gain before menopause

Brittle bones

Late menopause

First menstruation before the age of 12

Waist-hip ratio

Don't know

Page.23

21

24

9

15

16

13

3

7

14

24

50

Increased bone density

Natural hormone levels

Brittle bones

Birth of first child at an older age

Weight gain after menopause

Late menopause

Waist-hip ratio

First menstruation before the age of 12

Removal of ovaries

HRT

Heredital factors

Perceived risk factor for developing breast cancer (AsiaAsia)

% women

Page.24

45%

32%

27%

24%

9%

0% 10% 20% 30% 40% 50%

Increased risk of breast cancer

Weight gain

Will not alleviate symptoms

Info about increased risk of heartdisease

Breast problems

% of women

Largest hurdles preventing the use of HRTLargest hurdles preventing the use of HRT

Page.25

Perceived differences Perceived differences between various kinds of HRTbetween various kinds of HRT (Europe)(Europe)

45

18

14

5

2

2

5

33

1

0 10 20 30 40 50

Number, amount and kind of hormones

Number and kind of side effects or risk factors

Effectiveness in alleviating menopausal symptoms

Way of administrating

Safety of therapies

Bleeding

Effect on breasts

Other

Don't know

% women

99% of women are not aware of differences between HRT’s in relation to breast

99% of women are not aware of differences between HRT’s in relation to breast

Page.26

Perceived differences Perceived differences between various kinds of HRTbetween various kinds of HRT (Asia)(Asia)

6% 39% 22% 27% 24% 19% 18% 23% 18%

Effect on breastsEffective in alleviating symptomsBrand nameNo. and kind of s/eAmount of hormonesNo. and kind of hormonesNo. and kind of risk factorsSafety of the therapiesDon't know

94% of women are not aware of differences between HRTs in relation to breast

Page.27

FindingsFindings

Menopause

Breast

Sexual well-being

Page.28

RReduced sexual functioningeduced sexual functioning

Experience reduced sexual functioning and/or reduced libido

Yes

No

Don't Know71%

25%

4%

Page.29

DDiscomfort during sexiscomfort during sex

Experienced vaginal pain, dryness or discomfort during sex

Yes

No

Don't Know75%

19%

6%

Page.30

On relation with partner: 66%

On femininity 64%

On quality of life 65%

On self esteem 34%

RReduced sexual interest has a negative impacteduced sexual interest has a negative impact

Page.32

Importance of sexual relationship before and after the menopause

Before menopause

19%

19%

15%

10%

12%

28%

55%

57%

55%

60%

51%

54%

19%

22%

19%

29%

23%

9%

3%

10%

1%

5%

2%

9%

1%

1%

7%

4%Total (N=1000)

China (N=300)

Taiwan (N=150)

Hong Kong(N=100)

Thailand (N=150)

Malaysia (N=300)

Now

8%

7%

9%

3%

3%

12%

37%

43%

31%

31%

33%

38%

40%

40%

41%

58%

39%

33%

11%

7%

17%

8%

15% 10%

10%

2%

7%

2%

5%

Very important Important Unimportant Very unimportant Don’t know

Page.33

Base: All respondents

Seek treatment Take medication/drugs

31% 63% 6%Total (N=1000) 24% 69% 7%

Don’t knowYES NO

Willingness of all respondent to seek or take treatment, if Willingness of all respondent to seek or take treatment, if confronted with sexual symptomsconfronted with sexual symptoms

not not

Page.34

Base: All respondents

Take hormone replacement therapy

19% 71% 9%

Don’t knowYES NO

Willingness to take HRT for sexual problemsWillingness to take HRT for sexual problems

Not

Page.36

56

12

1

7

6

1

0 10 20 30 40 50 60

Never discussed

Female friends

Family

Friends

Doctor

Partner

% women

More than half the women don’t discuss problems More than half the women don’t discuss problems with partners, only 6% with their doctorswith partners, only 6% with their doctors

18

Page.37

With improved sexual functioning I would enjoy life moreWith improved sexual functioning I would enjoy life more

Yes

No

Don't know61%34%

5%

Base: All respondents

Page.38

75% women would talk about it if doctors bring it up75% women would talk about it if doctors bring it up

If my doctor would bring up the subject of sexual problems himself, it would trigger me to talk about it

Yes

No

Don't know75%

23%

2%

Page.39

Summary and conclusionsSummary and conclusions

Sleeplessness and hot flushes are most common reason for seeking treatment for Asian women

HRT use is much lower in Asian than in European women

Breast cancer risk (and other perceived AEs) major hurdle for acceptance of hormone treatment

Perceived efficacy differences between HRT options, no awareness in differences in breast (cancer) effects

Page.40

Summary and conclusionsSummary and conclusions

Most women experience reduction in libido / sexual functioning

This affects their femininity, QoL and self esteem

Most women uninformed about treatment options and/or unwilling to seek or take treatment

6% discuss symptoms with their doctor, 75% willing to discuss in doctor initiates

61% would enjoy life more if sexual functioning improved

Page.41

Adequate information, less media driven Adequate information, less media driven scare storiesscare stories

Doctors perceptive of the potential symptoms Doctors perceptive of the potential symptoms (and worries) they may experience - but dare (and worries) they may experience - but dare not discuss pro-activelynot discuss pro-actively

Menopausal womens’ needsMenopausal womens’ needs