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Changes in central circulation in premenopausal women during application of an estradiol valerate-norgestrel
Insights
Premenopausal women using estrogen-progestogen therapy showed no significant changes in cardiovascular function or physical capacity over 12 months. A temporary increase in blood pressure was observed, suggesting vascular adaptation.
Area of Science:
- Cardiovascular Physiology
- Endocrinology
- Sports Medicine
Background:
- Hormone replacement therapy (HRT) is used for menopausal symptoms.
- Estrogen-progestogen combinations are common HRT formulations.
- Understanding the cardiovascular effects of HRT in premenopausal women is important.
Purpose of the Study:
- To evaluate the effects of estrogen-progestogen substitution on cardiovascular parameters and physical working capacity in premenopausal women.
- To compare these effects with a control group not receiving hormonal treatment.
Main Methods:
- Seventeen premenopausal women received estrogen-progestogen therapy (2 mg estradiol valerate and 0.5 mg norgestrel).
- Cardiovascular assessments included orthostatic reaction, blood pressure, hemoglobin, blood volume, and heart volume.
- Physical working capacity was measured using a bicycle ergometer.
- Measurements were taken at baseline, 6 months, and 12 months, with a control group of 12 women.
Main Results:
- No significant changes were observed in orthostatic pulse reaction, physical working capacity, total hemoglobin, or heart volume over 12 months.
- Heart volume increased in both treated and control groups, with no significant difference between them.
- Systolic and diastolic blood pressure showed a transient increase in the treated group during the initial months, returning to baseline by 12 months.
Conclusions:
- Estrogen-progestogen therapy in premenopausal women did not adversely affect cardiovascular function or physical capacity over a 12-month period.
- The observed transient blood pressure increase may indicate an adaptive vascular response, similar to that seen with low-dose contraceptives.
Abstract:
The orthostatic circulatory reaction, the physical working capacity on a bicycle ergometer, the indirectly measured blood pressure at rest and after the ergometer test, the total hemoglobin content, blood volume and the heart volume in supine position were all determined on three separate occasions in the 17 premenopausal women who were taking an estrogen-progestogen combination as premenopausal substitution (2 mg estradiol valerate and 0.5 mg norgestrel, CyclabilR, Schering AG). Twelve women not receiving steroid treatment served as controls. The examinations were performed once prior to the commencement of the medication and 6 and 12 months thereafter. The orthostatic pulse reaction, the physical working capacity, the total amount of hemoglobin and heart volume did not change during the 12 months. Heart volume increased in both groups but there was no difference between the groups. Systolic and diastolic blood pressure increased slightly in the treated group during the first months but returned towards the initial values at 12 months. The transitory blood pressure increase when using the estrogen-progestogen combination in the premenopause during 12 months is similar to that earlier reported in younger women taking low-dose steroid contraceptives (8). It is conceivable that an adaptative mechanism in the vascular system will work in both situations.