Estriol (E3) replacement improves endothelial function and bone mineral density in very elderly women

Area of Science:

• Endocrinology
• Geriatrics
• Cardiovascular Science

Background:

• Estrogen decline affects bone mineral density (BMD) and endothelial function in postmenopausal women.
• Estriol (E3), a weaker estrogen, is being investigated for hormone replacement therapy (HRT) in the elderly.

Purpose of the Study:

• To investigate the effects of estriol (E3) on endothelial function and BMD in very elderly women.
• To assess the efficacy of E3 in hormone replacement therapy (HRT) for improving vascular health and bone density.

Main Methods:

• A 30-week randomized controlled trial involving 24 very elderly women (mean age 80 years).
• Participants received either estriol (E3) treatment (2 mg/day) or a placebo (CaCl2).
• Assessed endothelium-dependent flow-mediated dilatation (FMD), endothelium-independent dilatation, BMD, plasma lipids, apoproteins, and bone resorption markers.

Main Results:

• Estriol treatment significantly increased plasma E2 and E3 levels.
• HRT with E3 improved FMD, plasma nitrite/nitrate, and cGMP levels, indicating enhanced endothelial function.
• BMD increased in the E3 group while decreasing in the control group, with significant differences in bone resorption markers.

Conclusions:

• Estriol (E3) effectively improves endothelial function and bone mineral density (BMD) in very elderly women.
• E3 demonstrates anti-atherosclerotic effects by improving vascular function and inhibiting bone resorption.
• Estriol shows promise as a beneficial HRT option for elderly patients, particularly for bone health and cardiovascular protection.