Title: Exploring Hormone Replacement Therapy Dynamics Among Menopausal Women in
Kuala Lumpur – A Community Based Survey.
Version: 1 Date: 13 Jul 2024
Reviewer:  Phuc Nhon Nguyen
Reviewer's report:
Thank you for your work concerning women’s health in menopause stage. I have some
comments in constructive way. Please address these comments point-by-point:
-Introduction should be shortened and focused.
-Please clarify this study sample collection is probabilistic/random samples or nonprobabilistic/
nonrandom samples. The authors mentioned convenience sampling techniques and used the
study sample size .
-The study population was collected in community/public places. Why the study did not collect
the participants at hospital. The characteristics of postmenopausal women at hospital are not the
same. Thus, the title should be add the place “community based study”.
-Did the Malaysian questionnaire tools have been studied with an external validation for
Cronbach's alpha coefficient previously?
-How long time the questionnaire survey costs for one participant?
-Did the study have a gift/money paid for participants?
-How many women refused to participated in the study? Please add the study flowchart with
inclusion and exclusion data.
-Who performed the face-to-face survey? Please describe clearly.
-Please defined the place:“Pasar Malam”. The name of place should be described clearly.
-Household income per month should be defined. Income was calculated on woman’s income
or a couple’s income.
-Please define “menopausal age”. The age range of 40-49 was included in this study with nearly
130 participants over 404 women. This range of age is earlier than normal age for menopausal
women. Did the study include the premature ovarian insufficiency?
-Group with and without hormonal therapy treatment should be analyzed.
-Did the study concern the effective treatment: before and after treatment?
-The time duration of HRT therapy should be included.
-Please include all types of HRT drugs.
-Factors relating to use and non-use hormonal therapy should be analyzed.
-Please include the baseline characteristics of study population such as BMI, diabetes, and
hypertension since it is highly related to endometrial cancer. Nguyen PN, Nguyen VT.
Evaluating Clinical Features in Intracavitary Uterine Pathologies among Vietnamese Women
Presenting with Peri-and Postmenopausal Bleeding: A Bicentric Observational Descriptive
Analysis. J Midlife Health. 2022;13(3):225-232. doi:10.4103/jmh.jmh_81_22
-If the study population revealed the women with vaginal bleeding, what is the management.
Did the study give an advice for endometrial cancer screening? Nguyen PN, Nguyen VT.
Endometrial thickness and uterine artery Doppler parameters as soft markers for prediction
of endometrial cancer in postmenopausal bleeding women: a cross-sectional study at tertiary
referral hospitals from Vietnam. Obstet Gynecol Sci. 2022;65(5):430-440. doi:10.5468/
ogs.22053
-The discussion is too long. Please focus and compared with other studies in Asian countries
and western countries.
Some other minor points:
- Hormone Replacement Therapy (HRT) should be written in full-word at the first mention in
each section.
-English editing is required. The below sentence is difficult to understand. For #ample: “The
combination of estrogen and progesterone therapy will be recommended for those women with
intact uterus. This is because estrogen alone might cause the endometrial wall to grow too thick.”
-Citation style of references should be followed by journal’s instruction.
Best regards,