Cerebrovascular reactivity across the menstrual cycle in young healthy women

This study evaluated the relationship of cerebrovascular reactivity in young healthy women with changes in concentrations of circulating ovarian hormones throughout the menstrual cycle. Nineteen healthy nulliparous, right-handed, regularly menstruating women (age 23-25 years) underwent color-coded duplex sonography of the common (CCA), internal (ICA) and external (ECA) carotid arteries on both sides. Mean blood flow velocity values measured before and ten minutes after intravenous administration of 1000 mg acetazolamide (ACE) were assessed in relation to the serum concentration of estrogen and progesterone on days 5, 13 and 26 of the cycle. After ACE administration flow velocity in the right CCA and ICA increased by 23% and 35% on day 5, 12% and 31% on day 13 and 30% and 47% on day 26 respectively, and the changes were significantly larger on the right side (F=6.793 and F=4.098 respectively; both p<0.05). Changes in blood flow velocity in the right CCA and ICA after ACE injection were significantly associated with ovarian hormone concentrations (F=3.828, P=0.028 and F=3.671, P=0.032 respectively). We conclude that cerebrovascular reactivity changes across the menstrual cycle are associated with ovarian steroid hormone changes, and are asymmetric. The results imply that vasculature of the right hemisphere may undergo cyclic vasodilation across the menstrual cycle and this effect should be considered in studies of cerebrovascular reactivity in women with migraine and mood disorders.